Marie Ellen Goodine

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2733 Issued in CT

Practice address

1177 Silas Deane Hwy Ste 3
Wethersfield, CT 06109-4332

Phone

(860) 837-0401

NPI assigned

Feb 28, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, CT

  Medicare reassignment NPD

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

{
    "created_epoch": "1582848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1023642998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "768 S QUAKER LN",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061101223",
            "telephone_number": "860-798-6758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1177 SILAS DEANE HWY STE 3",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094332",
            "telephone_number": "860-837-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODINE",
        "first_name": "MARIE",
        "middle_name": "ELLEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-28",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "2733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerome I Glazer, O.D.
• Daniel Gerardo Gomez, DO
• Good Faith Care Inc Dba Good Faith Care
• Good Faith Care Inc Dba Good Faith Care
• Good Faith Phlebotomy Mobile Care LLC
• Verona Sonia Gordon
• Nina Marie Grabon, AGACNP-BC
• Timothy Edwin Graboski, PTA
• Greater Hartford Pediatrics LLC
• Kari Ann Greaves, LADC

• Clinical Social Worker in Wethersfield, CT
• Providers in Wethersfield, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.