Katherine Gardner Goetz, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

200 Lakewood Blvd
Park Forest, IL 60466-1718

Phone

(708) 481-9799

NPI assigned

Dec 11, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Katherine Goetz Licsw LLC

  • Adolescent and Children Mental Health Clinic/Center
  • West Burke, VT
  • NPI 1275252033
  NPD Authorized official

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043370208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6635 N MOZART ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606454307",
            "telephone_number": "773-262-6133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LAKEWOOD BLVD",
            "city": "PARK FOREST",
            "state": "IL",
            "postal_code": "604661718",
            "telephone_number": "708-481-9799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOETZ",
        "first_name": "KATHERINE",
        "middle_name": "GARDNER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esther Fulcher
• Xyavia Geigel, CERTIFIED NURSING AS
• Gentree Nutrition
• Latoya Giles-Shaw, COTA
• Paris Givhan
• Loretta R Golden-Jackson
• Sharrod David Graham, ATC,CSCS
• Grand Prairie Services
• Grand Prairie Services
• Grand Prairie Services

• Clinical Social Worker in Park Forest, IL
• Providers in Park Forest, 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 Jul 8, 2007; 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.