Annalaura Goodman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34007725A Issued in IN

Practice address

9250 Columbia Ave Ste 2E
Munster, IN 46321-3530

Phone

(219) 595-0043

Fax

(219) 237-2894

NPI assigned

Feb 16, 2012

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

Other identifiers 1

Other names 1

• Annalaura Kelley Former name

Medicare fee-for-service enrollment

Enrolled in IN, IL2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: ccin.annalaura.goodman@138327.advancedmd-direct.com

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.

• Southlake Community Mental Health Center Inc.

  dba Regional Mental Health Center

  • Clinic/Center
  • Merrillville, IN
  • NPI 1821081290
  Medicare reassignment NPD
• Beloved Community Family Wellness Center

  • Primary Care Clinic/Center
  • Chicago, IL
  • NPI 1760408439
  Medicare reassignment NPD
• Nwi Clarity Clinic

  • Clinical Social Worker
  • Munster, IN
  • NPI 1619412160
  NPD
• Beloved Community Family Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Blue Island, IL
  • NPI 1114278009
  NPD

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

{
    "created_epoch": "1329350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1093088379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 COLUMBIA AVE STE 2E",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463213530",
            "telephone_number": "219-595-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 COLUMBIA AVE STE 2E",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463213530",
            "telephone_number": "219-595-0043",
            "fax_number": "219-237-2894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "ANNALAURA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-16",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007725A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "945770015",
            "identifier": "MEDICARE",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNALAURA",
            "last_name": "KELLEY",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Esteban E Golombievski, MD
• Mary C Golubski, CRNA
• Raquel Gonzalez Heredia, MD
• Carlos Rafael Gonzalez Rendon, M.D.
• Amber Gonzalez, BCBA
• Hugh Michael Goodman
• Thottathil Viswanathan Gopan, MD
• Gope Dental P.C
• Krishnaveni Gorantla, MD
• Alan N Gordon, O.D.

• Clinical Social Worker in Munster, IN
• Providers in Munster, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.