MR. KEITH D JODWAY (NPI# 1912949413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912949413 |
| Entity Type | Individual |
| Full Name | MR. KEITH D JODWAY |
| Credential | LMHC, LCAC |
| Practice Address |
209 Tanglewood Dr Apt C Goshen IN 46526-1718 |
| Mailing Address |
211 E Washington St Goshen IN 46528-3322 |
| Practice Telephone | 5742200220 |
| Practice Fax Number | 5749757788 |
| Mailing Telephone | 5742200220 |
| Mailing Fax Number | 5745345778 |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2019-05-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
00228 | IN | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
39001485A | IN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | LICENSED MENTAL HEALTH COUNSELOR | 39001485A | 01 |
| IN | LICENSED CLINICAL ADDICTION COUNSELOR | 87000367A | 01 |
| Street Address |
209 TANGLEWOOD DR APT C |
| City | GOSHEN |
| State | IN |
| Zip Code | 46526-1718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558927764 | Maple City Counseling Center | Counselor | 209 Tanglewood Dr Apt C, Goshen, IN 46526-1718 | 2019-05-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134631344 | Heidi Kauffmann | Social Worker | 2606 Peddler's Village Rd. Suite 210, Goshen, IN 46526 | 2017-10-27 |
| 1952812034 | Blue Diamond Villas | Skilled Nursing Facility | 1510 Sandpiper Lane, Goshen, IN 46526 | 2017-10-17 |
| 1578086534 | Anthony Escotto | Physical Therapist | 223 North Chicago Avenue, Goshen, IN 46526 | 2017-07-21 |
| 1831544774 | April Noelle Hart | Registered Nurse | 2606 Peddlers Village Rd., Suite 215, Goshen, IN 46526 | 2016-04-28 |
| 1639530108 | Amanda Miller | Physical Therapy Assistant | 114 Watertower Court, Goshen, IN 46526 | 2016-03-11 |
| 1720486095 | Gloria White | Pharmacist | 4430 Elkhart Road, C/o Walgreens, Goshen, IN 46526 | 2014-12-18 |
| 1184982472 | Dianna Christine Hoover | Occupational Therapist | 1627 Autumn Blaze Lane, Goshen, IN 46526 | 2012-04-24 |
| 1629361357 | Amy Rebecca Pointon | Nurse Practitioner | 1615 Winsted Dr Ste 1, Goshen, IN 46526 | 2011-05-27 |
| 1659670685 | Michiana Eye Center LLC | Optometrist | 1747 Stafford Ct, Goshen, IN 46526 | 2011-03-16 |
| 1467759001 | Natasha Candace Pontius | Occupational Therapy Assistant | 2400 College Aveune, Goshen, IN 46526 | 2011-02-17 |
| Find all providers in zip 46526 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811538481 | Polly Mortensen | Counselor | 45 St John St, Goshen, NY 10924-1518 | 2019-10-03 |
| 1770052755 | Judy M. Culp | Counselor | 224 The Willows, Goshen, IN 46526-5846 | 2018-11-19 |
| 1396112702 | Laurie Ann Conklin | Counselor | 55 Main St Ste 6, Goshen, NY 10924-2163 | 2015-09-01 |
| 1356758551 | Sarah Jean White | Counselor | 2 Edgewood Rd, Goshen, NY 10924-2304 | 2014-07-20 |
| 1043523319 | Kristen Fortuna | Counselor | 3 Hatfield Ln Ste 1, Goshen, NY 10924-6732 | 2010-07-15 |
| 1982880977 | Elton L. Spade | Counselor | 22446 Spicewood Dr, Goshen, IN 46528-9156 | 2008-01-21 |
| 1255549192 | Christoher R. Weber | Counselor | 505 Revere Dr, Goshen, IN 46526-1231 | 2007-05-21 |
| 1720203946 | David B Moskowitz | Counselor | 102 Green St, Goshen, NY 10924-2017 | 2007-04-14 |
| 1023141355 | Claudine Ann Craig | Counselor | 3 Halfield Lane, Valvie Behavioral Medicine Ste 1, Goshen, NY 10924 | 2007-03-14 |
| 1851494843 | Frederick E Noll | Counselor | Route 17m, Suite 10, Goshen, NY 10924 | 2006-09-06 |
| Find all providers in GOSHEN | ||||
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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.