JEANIMARIE GOODWIN (NPI# 1558736769) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558736769 |
| Entity Type | Individual |
| Full Name | JEANIMARIE GOODWIN |
| Practice Address |
9815 Roosevelt Blvd Suite B Philadelphia PA 19114-1035 |
| Mailing Address |
680 American Ave Suite 302 King of Prussia PA 19406-4023 |
| Practice Telephone | 6106446464 |
| Practice Fax Number | 6109816078 |
| Mailing Telephone | 6106446464 |
| Mailing Fax Number | 6109816078 |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2015-12-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
9815 ROOSEVELT BLVD SUITE B |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19114-1035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548203839 | Uplekh Purewal | Anesthesiology | 9815 Roosevelt Blvd, Philadelphia, PA 19114-1011 | 2006-06-14 |
| 1144797689 | Christina Groves | Counselor | 9815 Roosevelt Blvd, Philadelphia, PA 19114-1035 | 2018-11-01 |
| 1346723962 | Alexander Jaffe | Counselor | 9815 Roosevelt Blvd, Philadelphia, PA 19114-1035 | 2018-09-10 |
| 1881172310 | Allan Terciano | Physical Therapist | 9815 Roosevelt Blvd, Philadelphia, PA 19114-1035 | 2018-08-06 |
| 1043705098 | Lily Dunlap | Counselor | 9815 Roosevelt Blvd, Philadelphia, PA 19114-1035 | 2018-06-22 |
| 1952804817 | Jessica Lyman | Counselor | 9815 Roosevelt Blvd, Philadelphia, PA 19114-1035 | 2018-03-16 |
| 1235647314 | Nicole Russo | Counselor | 9815 Roosevelt Blvd, Philadelphia, PA 19114-1035 | 2018-01-11 |
| 1316488315 | Maxim Healthcare Services Inc | Home Health | 9815 Roosevelt Blvd, Unit E, Philadelphia, PA 19114-1035 | 2017-03-10 |
| 1942663950 | Jason Horrox | Physical Therapist | 9815 Roosevelt Blvd, Philadelphia, PA 19114-1035 | 2016-03-29 |
| 1528428075 | Gina Cardillo | Counselor | 9815 Roosevelt Blvd, Suite B, Philadelphia, PA 19114-1035 | 2016-02-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029906 | Phuoc Nguyen | Nurse Anesthetist, Certified Registered | Jefferson Torresdale Hospital, 10800 Knights Rd, Philadelphia, PA 19114 | 2020-10-05 |
| 1053921932 | Priyanka Patel | Dentist | Philadelphia Dental Smiles, 9140 Academy Road, Philadelphia, PA 19114 | 2020-08-05 |
| 1215419080 | Thomas Patrick Gallagher | Specialist/Technologist | 2708 Ruth Way, Philadelphia, PA 19114 | 2018-08-29 |
| 1558840223 | Alexis Wenger | Early Intervention Provider Agency | 3810 Aubrey Ave, Phila, PA 19114 | 2018-08-13 |
| 1245759232 | Newlands Health | Clinic/Center | 9625 Frankford Ave., Philadelphia, PA 19114 | 2017-09-12 |
| 1619491453 | Nazareth Physician Services Inc | Social Worker | 9815 Roosevelt Blvd Ste G, Philadelphia, PA 19114 | 2017-08-02 |
| 1326561606 | L.s. Share & Love Support Coordinating Agency, LLC | Case Management | 3600 Red Lion Road, Apt 68c, Philadelphia, PA 19114 | 2017-07-19 |
| 1760911952 | Charles C Richards II | Counselor | 2555 Welsh Rd, Apt 407, Philadelphia, PA 19114 | 2017-06-09 |
| 1801338686 | April Neuls | Physical Therapy Assistant | 4213 Lackland Place, Philadelphia, PA 19114 | 2016-11-10 |
| 1114317583 | Siji Cyriac | Physical Therapist | 9501 State Road, Philadelphia, PA 19114 | 2015-01-23 |
| Find all providers in zip 19114 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235737412 | Tara Jenkins | Counselor | 6701 Woolston Ave, Philadelphia, PA 19138-2628 | 2020-10-11 |
| 1124635339 | Elizabeth Hoffman Sporer | Counselor | 1318 Marlborough St, Philadelphia, PA 19125-3215 | 2020-09-30 |
| 1437764933 | Elizabeth Richburg | Counselor | 5709 W Jefferson St, Philadelphia, PA 19131-3417 | 2020-09-11 |
| 1144833153 | Taylor Daly | Counselor | 7002 Cresheim Rd, Philadelphia, PA 19119-2535 | 2020-08-28 |
| 1871117093 | Arnold Tim Massaquoi | Counselor | 461 Aurania St, Philadelphia, PA 19128-4010 | 2020-06-03 |
| 1891315453 | Alice D Gresham | Counselor | 2025 Conlyn St, Philadelphia, PA 19138-2925 | 2020-04-23 |
| 1518587864 | Wesley G Harris IIi | Counselor | 1621 N 54th St, Philadelphia, PA 19131-4002 | 2020-04-16 |
| 1497383954 | R Denise Coles | Counselor | 7320 Sommers Rd, Philadelphia, PA 19138-1330 | 2020-03-31 |
| 1023645058 | Sicklecelldeiseasassociationofamericaphiladelphia/delawarevalleychapte | Counselor | 5300 Wynnefield Ave Fl 2, Philadelphia, PA 19131-2318 | 2020-03-27 |
| 1245873736 | Antonia Cianfrani | Counselor | 1901 S 9th St Ste 520, Philadelphia, PA 19148-2391 | 2019-10-28 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19114 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.