Sara Goudge, MA, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC00385 Issued in MN

Practice address

23306 Cree St Unit 106
Saint Francis, MN 55070-2307

Phone

(763) 220-0501

Fax

(763) 312-2056

NPI assigned

Nov 11, 2011

Last updated

Sep 9, 2021By 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 2

Addresses

Other names 1

• Sara Lawrence Former name

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Mental Health Counselor

Education

Other, 2009

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  MN

  Medicare reassignment
• Trilogy Counseling Services PLLC

  dba Trilogy Counseling

  • Professional Counselor
  • Princeton, MN
  • NPI 1497246433
  NPD (past)

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

{
    "created_epoch": "1320969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1083991525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5409 AMBASSADOR BLVD NW",
            "city": "SAINT FRANCIS",
            "state": "MN",
            "postal_code": "550709677",
            "telephone_number": "612-501-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23306 CREE ST UNIT 106",
            "city": "SAINT FRANCIS",
            "state": "MN",
            "postal_code": "550702307",
            "telephone_number": "763-220-0501",
            "fax_number": "763-312-2056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUDGE",
        "first_name": "SARA",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-11",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "385",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC00385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "LAWRENCE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ron D. Fischer, PT/ATC
• Sheri Monique Fischer, RN
• Krista Marie Flanagan, ATC
• Gentle Care Chiropractic (Johnson Family Chiropractic)
• Goodrich Pharmacy Inc (Goodrich Pharmacy St Francis)
• Matthew Haugen, CMT
• Katie Beth Hofkes, D.C.
• Ashlee Hommes
• Honesty Home Care LLC
• Kurtis Steven Huether, DDS

• Professional Counselor in Saint Francis, MN
• Providers in Saint Francis, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.