Individual provider Active NPI

Jannah S Goodell, LCSW, LPC, ATR-BC

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1104056456
Registry record updated Jul 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW004122 Issued in GA
Practice address
1010 Summit Pointe Way NE
Atlanta, GA 30329-4063
Phone
(678) 733-2728
NPI assigned
Jul 21, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC005371 GA
Clinical Social Worker 1041C0700X CSW004122 GA Primary
Art Therapist 221700000X 90-062

Addresses

Primary practice location

1010 Summit Pointe Way NE
Atlanta, GA 30329-4063

Mailing address

1010 Summit Pointe Way NE
Atlanta, GA 30329-4063
Phone (678) 733-2728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPC005371GAMDProfessional Counselor
CSW004122GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1248134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248134400000",
    "number": "1104056456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 SUMMIT POINTE WAY NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303294063",
            "telephone_number": "678-733-2728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 SUMMIT POINTE WAY NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303294063",
            "telephone_number": "678-733-2728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODELL",
        "first_name": "JANNAH",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "LCSW, LPC, ATR-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-21",
        "last_updated": "2009-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC005371",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004122",
            "primary": true
        },
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": null,
            "license": "90-062",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; 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.