Individual provider Active NPI

Willa Goins, CSC-AD

  • Addiction (Substance Use Disorder) Counselor
  • Baltimore, MD
National Provider Identifier
1104227909
Registry record updated Sep 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
SC1029 Issued in MD
Practice address
2225 N Charles St
Baltimore, MD 21218-5778
Phone
(410) 366-4360
Fax
(410) 366-4134
NPI assigned
Sep 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X SC1029 MD Primary

Addresses

Primary practice location

2225 N Charles St
Baltimore, MD 21218-5778

Mailing address

2225 N Charles St
Baltimore, MD 21218-5778
Phone (410) 366-4360

Other identifiers 1

IdentifierTypeStateIssuer
SC1029OtherMDPROFESSIONAL COUNSELOR AND THERAPIST

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
SC1029MDMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410393600000",
    "number": "1104227909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185778",
            "telephone_number": "410-366-4360",
            "fax_number": "410-366-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185778",
            "telephone_number": "410-366-4360",
            "fax_number": "410-366-4134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOINS",
        "first_name": "WILLA",
        "credential": "CSC-AD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-11",
        "last_updated": "2014-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "SC1029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL COUNSELOR AND THERAPIST",
            "identifier": "SC1029",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; 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.