Active NPI
Cynthia K Goeller, LCPC
- Professional Counselor
- Fredrick, MD
National Provider Identifier
1013053610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC-3565
- Practice address
- 1707 Rosemount Ave
Fredrick, MD 21702 - Phone
- (443) 900-5886
- NPI assigned
- Jan 30, 2007
- Last updated
- Jan 28, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LC-3565 | MD | Primary |
Addresses
Primary practice location
1707 Rosemount Ave
Fredrick, MD 21702
Mailing address
73 E Cayuga St
Moravia, NY 13118-9302
Phone (434) 900-5886
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC-3565 | MD | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548633600000",
"number": "1013053610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "73 E CAYUGA ST",
"city": "MORAVIA",
"state": "NY",
"postal_code": "131189302",
"telephone_number": "434-900-5886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1707 ROSEMOUNT AVE",
"city": "FREDRICK",
"state": "MD",
"postal_code": "21702",
"telephone_number": "443-900-5886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOELLER",
"first_name": "CYNTHIA",
"middle_name": "K",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-30",
"last_updated": "2019-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC-3565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fredrick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.