Carolyn Ann Goosby, DMIN, MDIV, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

9701 S 49TH Ave
Oak Lawn, IL 60453-3005

Phone

(773) 507-3770

Fax

(708) 563-0114

NPI assigned

Dec 8, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1023614864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DR CAROLYN A GOOSBY",
            "address_2": "8108A CONCORD LANE",
            "city": "JUSTICE",
            "state": "IL",
            "postal_code": "60458",
            "telephone_number": "773-507-3770",
            "fax_number": "708-563-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 S 49TH AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533005",
            "telephone_number": "773-507-3770",
            "fax_number": "708-563-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOSBY",
        "first_name": "CAROLYN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DMIN, MDIV, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-08",
        "last_updated": "2024-04-30",
        "certification_date": "2020-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salvador Gonzalez Jr., OD
• Mekapeu Grace Gonzreu
• Nicholas William Goodmanson, MD
• Peyton Anne Goodrich
• Nihal Gooneratne, MD
• Marnyese L Goosby, APRN
• Prit Gor, PHARMD
• Erin Eileen Gordon, DO
• Melanie Jaynee Gordon, MD
• Rachel Gordon, PA

• Clinical Social Worker in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.