KRISTY B GOODWIN (NPI# 1295214732) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295214732 |
| Entity Type | Individual |
| Full Name | KRISTY B GOODWIN |
| Credential | LAC |
| Practice Address |
2003 Se Walton Blvd Bentonville AR 72712 |
| Mailing Address |
2400 S 48th St Springdale AR 72762-6683 |
| Practice Telephone | 4797256000 |
| Practice Fax Number | 4797504843 |
| Mailing Telephone | 4797502020 |
| Mailing Fax Number | 4797504843 |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2018-08-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
A1808116 | AR | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2508 Se 20th St, Bentonville, AR 727124008 | 4792739088 | 4797504843 |
| Street Address |
2003 SE WALTON BLVD |
| City | BENTONVILLE |
| State | AR |
| Zip Code | 72712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194773879 | Robin Bromley | Social Worker | 2003 Se Walton Blvd, Bentonville, AR 72712-3725 | 2006-05-04 |
| 1285235598 | Ragon Sprabery | Case Manager/Care Coordinator | 2003 Se Walton Blvd, Bentonville, AR 72712-3725 | 2020-11-03 |
| 1992304166 | George Palestino | Case Manager/Care Coordinator | 2003 Se Walton Blvd, Bentonville, AR 72712-3725 | 2020-10-20 |
| 1356948095 | Shan Evans | Case Manager/Care Coordinator | 2003 Se Walton Blvd, Bentonville, AR 72712-3725 | 2020-10-06 |
| 1982201620 | Quinn Emett | Case Manager/Care Coordinator | 2003 Se Walton Blvd, Bentonville, AR 72712-3725 | 2020-10-06 |
| 1851907935 | Taylor Goff | Case Manager/Care Coordinator | 2003 Se Walton Blvd, Bentonville, AR 72712-3725 | 2020-09-23 |
| 1679189757 | Macy Marshall | Case Manager/Care Coordinator | 2003 Se Walton Blvd, Bentonville, AR 72712-3725 | 2020-09-23 |
| 1588278493 | Elizabeth Faulkenbury | Counselor | 2003 Se Walton Blvd, Bentonville, AR 72712-3725 | 2020-09-08 |
| 1194339093 | Grace Daniel | Case Manager/Care Coordinator | 2003 Se Walton Blvd, Bentonville, AR 72712-3725 | 2020-09-08 |
| 1275146094 | Steffanie Naples | Social Worker | 2003 Se Walton Blvd, Bentonville, AR 72712-3725 | 2020-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427662345 | Bentonville Ambulatory Surgery Center, LLC | Pain Medicine | 2902 We Mid-cities Dr, Bentonville, AR 72712 | 2020-09-08 |
| 1942837059 | Amy Crumpton | Counselor | 3504 Se Riveria Road, Bentonville, AR 72712 | 2020-03-26 |
| 1295361509 | Unbridled Holdings LLC | Physical Therapy Assistant | 9900 Price Coffee Rd, Bentonville, AR 72712 | 2020-03-18 |
| 1649803552 | Hanna Kathryn Baxendale | Pediatrics | 2900 Medical Pkwy, Ste #370, Bentonville, AR 72712 | 2020-02-19 |
| 1740746635 | Meredith C Hodges | Counselor | 2508 Se 2oth St, Bentonville, AR 72712 | 2019-02-15 |
| 1609352566 | Tripharma Inc | Pharmacy | 3500 Sw Regional Airport Blvd Ste 2, Bentonville, AR 72712 | 2018-07-13 |
| 1811406747 | Upspring Therapy, LLC | Counselor | 2106 Sw Walton Blvd, Suite B, Bentonville, AR 72712 | 2017-09-22 |
| 1023536836 | Charlotte Yuvonne Hoyle | Case Manager/Care Coordinator | 2005 S.e Walton Blvd., Bentonville, AR 72712 | 2017-08-31 |
| 1508399502 | Rosanna Nicole Rephan | Nurse Practitioner | 3101 14th St, Mercy Convenient Care, Bentonville, AR 72712 | 2017-04-06 |
| 1417305517 | Charlotte Lennette Stephenson | Behavioral Analyst | 2005 S.e. Walton Blvd., Bentonville, AR 72712 | 2016-05-31 |
| Find all providers in zip 72712 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760009716 | Serenity and Soul Counseling LLC | Counselor | 1202 Ne Mcclain Rd Ste 2002, Bentonville, AR 72712-3875 | 2020-06-25 |
| 1942837059 | Amy Crumpton | Counselor | 3504 Se Riveria Road, Bentonville, AR 72712 | 2020-03-26 |
| 1215571534 | Scott Francis Butler | Counselor | 305 Nw Palomino St, Bentonville, AR 72712-6472 | 2019-10-30 |
| 1740746635 | Meredith C Hodges | Counselor | 2508 Se 2oth St, Bentonville, AR 72712 | 2019-02-15 |
| 1811406747 | Upspring Therapy, LLC | Counselor | 2106 Sw Walton Blvd, Suite B, Bentonville, AR 72712 | 2017-09-22 |
| 1417495193 | Noel Christine Johnson | Counselor | 3909 Ne Nightingale, Bentonville, AR 72712-8903 | 2017-02-02 |
| 1992193361 | Lauren E Coles | Counselor | 809 Se 28th St Ste 1, Bentonville, AR 72712-4268 | 2015-01-07 |
| 1750714150 | William Burnett | Counselor | 2705 Se G St, Suite 9, Bentonville, AR 72712-3740 | 2013-08-21 |
| 1164795001 | Ronald Henderson | Counselor | 7807 Blue Jay Way, Bentonville, AR 72712-0000 | 2012-02-22 |
| 1184921603 | James Brandon Humphreys | Counselor | 108 E Central Ave Ste 210, Bentonville, AR 72712-5396 | 2011-02-18 |
| Find all providers in BENTONVILLE | ||||
| City | BENTONVILLE |
| Zip Code | 72712 |
Please comment or provide details below to improve the information on KRISTY B GOODWIN.
| 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.