Active NPI
Mark Jeffrey Goodman, LMHC
- Mental Health Counselor
- Seattle, WA
National Provider Identifier
1093158354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LH00010410
- Practice address
- 210 W Galer St
Seattle, WA 98119-3332 - Phone
- (206) 605-3441
- NPI assigned
- Apr 16, 2013
- Last updated
- Apr 16, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LH00010410 | WA | Primary |
Addresses
Primary practice location
210 W Galer St
Seattle, WA 98119-3332
Mailing address
832 NW 58TH St
Seattle, WA 98107-2832
Phone (206) 605-3441
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 29, 2024 through Dec 29, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LH00010410 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366070400000",
"number": "1093158354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "832 NW 58TH ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981072832",
"telephone_number": "206-605-3441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 W GALER ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981193332",
"telephone_number": "206-605-3441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODMAN",
"first_name": "MARK",
"middle_name": "JEFFREY",
"name_prefix": "Mr.",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-04-16",
"last_updated": "2013-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH00010410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.