Provider Demographics
NPI:1578396586
Name:GOINS, SHAWONNA LYNN
Entity type:Individual
Prefix:
First Name:SHAWONNA
Middle Name:LYNN
Last Name:GOINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1867 CRANE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4910
Mailing Address - Country:US
Mailing Address - Phone:601-362-8776
Mailing Address - Fax:
Practice Address - Street 1:144 S THOMAS ST STE 102
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-5332
Practice Address - Country:US
Practice Address - Phone:662-350-3914
Practice Address - Fax:662-350-3921
Is Sole Proprietor?:No
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor