Individual provider Active NPI

John Vincent Goldrich, LMHP

  • Mental Health Counselor
  • Lincoln, NE
National Provider Identifier
1104991199
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1430 Issued in NE
Practice address
315 S 9TH St
Lincoln, NE 68508-2247
Phone
(402) 477-8278
NPI assigned
Nov 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1430 NE Primary

Addresses

Primary practice location

315 S 9TH St
Lincoln, NE 68508-2247

Mailing address

7141 S 32ND St
315 South 9TH Street Suite 15
Lincoln, NE 68516-4866
Phone (402) 421-3814

Other identifiers 2

IdentifierTypeStateIssuer
15426OtherNEMIDLANDS CHOICE
82369OtherNEBLUE CROSS BLUE SHIELD NE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20110518000619 NE Practitioner - Clinical Social Worker 8325224850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2900 S 70TH St
Suite 160
Lincoln, NE 68506-3733
Phone (402) 304-0403

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
765NEMDAddiction (Substance Use Disorder) Counselor
1430NEMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Smooth Sailing LLC Mental Health CurrentSince May 1, 2020 Accepting new patients

Locations

2900 S 70th St
Ste 160
Lincoln, NE 68506
Phone (402) 477-8278

Organizations & group practices 1

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": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104991199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7141 S 32ND ST",
            "address_2": "315 SOUTH 9TH STREET SUITE 15",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685164866",
            "telephone_number": "402-421-3814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S 9TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685082247",
            "telephone_number": "402-477-8278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDRICH",
        "first_name": "JOHN",
        "middle_name": "VINCENT",
        "name_prefix": "Mr.",
        "credential": "LMHP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "1430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "15426",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NE",
            "identifier": "82369",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.