National Provider Identifier Database

JASON H GOODWIN, LCPC, CDAC – NPI #1174621627
Professional


Contact Information

JASON H GOODWIN, LCPC, CDAC
1417 N. 4TH ST.
COEUR D'ALENE, ID83814
Phone: 208-292-2188
Fax: 208-292-2189
Website:
Specialty Taxonomy Code
* Professional 101YP2500X

* Indicates primary specialty

NPI Profile & details for JASON H GOODWIN

NPI Number 1174621627
Credentials LCPC, CDAC
Entity Individual
Enumeration date 09/20/2006
Last updated 08/04/2011 - About 15 years ago
Sole proprietor1 No
Identifiers
  • ID License #: LPC-3639
  • ID Medicaid: 807281800
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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