Samantha Kaye Goodwin, | |
125 S Main Cross St, Louisa, KY 41230-1065 | |
(606) 638-0938 | |
Not Available |
Full Name | Samantha Kaye Goodwin |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 125 S Main Cross St, Louisa, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1407502602 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 254526 (Kentucky) | Secondary |
1041C0700X | Social Worker - Clinical | 257688 (Kentucky) | Primary |
Entity Name | Chronic Illness Counseling Center Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1548839285 PECOS PAC ID: 3274930896 Enrollment ID: O20210924001452 |
Mailing Address | Practice Location Address |
---|---|
Samantha Kaye Goodwin, 125 S Main Cross St, Louisa, KY 41230-1065 Ph: (606) 638-0938 | Samantha Kaye Goodwin, 125 S Main Cross St, Louisa, KY 41230-1065 Ph: (606) 638-0938 |
Tiffany Short, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 125 S Main Cross St, Louisa, KY 41230 Phone: 606-638-0938 | |
Eugenia Wilson, CSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 125 S Main Cross St, Louisa, KY 41230 Phone: 606-638-0938 | |
Emily Jones-gray, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 125 S Main Cross St, Louisa, KY 41230 Phone: 606-638-0938 | |
Christie Lynn Thomas, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 125 S Main Cross St, Louisa, KY 41230 Phone: 606-638-0938 | |
Tiffanie Conley, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 125 S Main Cross St, Louisa, KY 41230 Phone: 606-638-0938 | |
Jane Burgess Wallen, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 60 Professional Park Dr, Louisa, KY 41230 Phone: 606-638-4332 Fax: 606-638-4394 | |
Alexandria Heaton, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 125 S Main Cross St, Louisa, KY 41230 Phone: 606-638-0938 |