Active NPI
Madison Brooke Goins, BSW
- School Social Worker
- Buncombe, IL
National Provider Identifier
1104628817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- Practice address
- 164 Main St
Buncombe, IL 62912-2296 - Phone
- (618) 697-7358
- NPI assigned
- Mar 25, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| School Social Worker | 1041S0200X | Primary |
Addresses
Primary practice location
164 Main St
Buncombe, IL 62912-2296
Mailing address
170 Miller LN
Anna, IL 62906-3353
Phone (618) 697-7358
Other practice location 1
4580 Mount Pisgah Rd
Cypress, IL 62923-2139
Phone (618) 697-7358
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742860800000",
"number": "1104628817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "170 MILLER LN",
"city": "ANNA",
"state": "IL",
"postal_code": "629063353",
"telephone_number": "618-697-7358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "164 MAIN ST",
"city": "BUNCOMBE",
"state": "IL",
"postal_code": "629122296",
"telephone_number": "618-697-7358"
}
],
"practiceLocations": [
{
"address_1": "4580 Mount Pisgah Rd",
"address_purpose": "LOCATION",
"city": "Cypress",
"state": "IL",
"postal_code": "629232139",
"country_code": "US",
"telephone_number": "618-697-7358",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOINS",
"first_name": "MADISON",
"middle_name": "BROOKE",
"credential": "BSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-25",
"last_updated": "2025-03-25",
"certification_date": "2025-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Buncombe, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.