Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | MH8009 | FL |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 4269 | FL |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | MH8009 | FL |
Y | 101YM0800X | Mental Health Counselor | MH8009 | FL |
N | 101YP2500X | Professional Counselor | MH8009 | FL |
N | 101YS0200X | School Counselor | 651278 | FL |
NPI | 1073832077 |
---|---|
Provider Name | Mrs. Mary Elisabeth Beikirch-Godwin |
First Address | Lakeland, FL 33813-2512 |
Second Address | Lakeland, FL 33813-2512 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2010 |
Last Update Date | 04/06/2011 |