person
Mr. Keith D Jodway, LMHC,LCAC
Mental Health Counselor in Goshen, Indiana
NPI 1912949413

Keith D Jodway is a Mental Health Counselor based in Goshen, IN and is specialized in Mental Health. Keith D Jodway practices in Goshen, IN and has the professional credentials of LMHC,LCAC. The NPI Number for Keith D Jodway is 1912949413 and holds a License No. 00228 (Indiana).

The current practice location address for Keith D Jodway is 209 Tanglewood Dr Apt C, Goshen, IN and can be reached out via phone at 574-220-0220 and via fax at 574-975-7788.

Location: 209 Tanglewood Dr Apt C, Goshen, IN, 46528-3322
person
Provider Profile Details
NPI Number
1912949413
Provider Name
Keith D Jodway
Credential
LMHC,LCAC
Provider Entity Type
Individual
Gender
Male
Address
209 Tanglewood Dr Apt C, Goshen, IN, 46528-3322
Phone Number
574-220-0220
Fax Number
574-975-7788
Provider Enumeration Date
06/11/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
87000367A 01 IN LICENSED CLINICAL ADDICTION COUNSELOR
39001485A 01 IN LICENSED MENTAL HEALTH COUNSELOR
institution
Provider Business Practice Location Address Details
Address
209 Tanglewood Dr Apt C
City
State
Zip
46526-1718
Phone Number
574-220-0220
Fax Number
574-975-7788
person
Provider Business Mailing Address Details
Address
209 Tanglewood Dr Apt C
City
State
Zip
46526-1718
Phone Number
574-220-0220
Fax Number
574-975-7788
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
39001485A (Indiana)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
00228 (Indiana)
Definition
Definition to come...
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