Provider Demographics
NPI:1619760014
Name:GOODWIN, NADINE (LADC)
Entity type:Individual
Prefix:
First Name:NADINE
Middle Name:
Last Name:GOODWIN
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7551 YOUNG CIR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-1337
Mailing Address - Country:US
Mailing Address - Phone:775-250-0458
Mailing Address - Fax:
Practice Address - Street 1:2010 W MOANA LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-5277
Practice Address - Country:US
Practice Address - Phone:775-250-0458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01883-L101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV00384-COtherNEVADA STATE BOARD OF EXAMINERS FOR ALCOHOL, DRUG AND GAMBLING COUNSELORS
NV01883-LOtherNEVADA STATE BOARD OF EXAMINERS FOR ALCOHOL, DRUG AND GAMBLING COUNSELORS
NV00546-SOtherNEVADA STATE BOARD OF EXAMINERS FOR ALCOHOL, DRUG AND GAMBLING COUNSELORS