| Doctor Name: | PETER H GOODWIN |
| NPI Number: | 1013240308 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMHC |
| License Number: | 5481 |
| Business Practice Address: | 1114 Plaza Del Norte Suite B Espanola, NM - 875323216 |
| Business Phone Number: | 5057538933 |
| Business Fax Number: | 5057539811 |
| Mailing Address: | 1114 Plaza Del Norte, Suite B ESPANOLA |
| State: | NM |
| Postal Code: | 875323216 |
| Phone Number: | 5057538933 |
| Fax Number: | 5057539811 |
| NPI Enumeration Date: | 09/17/2009 |
| NPI Last Update Date: | 10/20/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 5481 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |