Individual provider Active NPI

Bryan Kevin Goin, LSCSW, LCSW

  • Clinical Social Worker
  • Overland Park, KS
National Provider Identifier
1104339951
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4062 Issued in KS
Practice address
7806 Hardy St
Overland Park, KS 66204-2640
Phone
(913) 963-9457
NPI assigned
Nov 14, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4062 KS Primary
Clinical Social Worker 1041C0700X 2017039125 MO

Addresses

Primary practice location

7806 Hardy St
Overland Park, KS 66204-2640

Mailing address

7806 Hardy St
Overland Park, KS 66204-2640
Phone (913) 963-9457

Other practice location 1

6637 E 134th Ter
Grandview, MO 64030-3237
Phone (913) 963-9457

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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

Enrollment IDStateProvider typePAC IDDetails
I20181011000686 KS Practitioner - Clinical Social Worker 9436401932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lavender Springs Behavioral Health LLCGroup PAC ID 6406296714, 3 clinicians

Practice addresses (Care Compare)

15310 W 89TH PL
Lenexa, KS 66219-1128
Phone (913) 523-6081

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4062KSMDClinical Social Worker
2017039125MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lavender Springs Behavioral Health LLC Clinical CurrentSince Jun 1, 2024 Accepting new patients
Leeker Enterprises Inc Clinical PastSince Oct 5, 2019 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1104339951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7806 HARDY ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662042640",
            "telephone_number": "913-963-9457",
            "fax_number": "913-392-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7806 HARDY ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662042640",
            "telephone_number": "913-963-9457"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6637 E 134th Ter",
            "address_purpose": "LOCATION",
            "city": "Grandview",
            "state": "MO",
            "postal_code": "640303237",
            "country_code": "US",
            "telephone_number": "913-963-9457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOIN",
        "first_name": "BRYAN",
        "middle_name": "KEVIN",
        "credential": "LSCSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-14",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "4062",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2017039125",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.