Carly Goodkin

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MF001270 Issued in PA

Practice address

10755 Scripps Poway Pkwy Unit 642
San Diego, CA 92131-6211

Phone

(484) 441-3309

NPI assigned

Jan 16, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1610755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1114516820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10755 SCRIPPS POWAY PKWY UNIT 642",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921313924",
            "telephone_number": "484-441-3309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10755 SCRIPPS POWAY PKWY UNIT 642",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921316211",
            "telephone_number": "484-441-3309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODKIN",
        "first_name": "CARLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-16",
        "last_updated": "2024-06-21",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "122284",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "PA",
            "license": "MF001270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Korrin Aldine Goode, OD
• Stephen Anthony Gooden
• Kelly M Goodin, DDS
• Amanda Gooding, PHD
• Ava Lee Goodjohn
• Mindy Goodlett, PHYSICIAN ASSISTANT
• Xavier Goodloe
• Glenn Putnam Goodlove, LCSW
• Gale Kirk Goodlow II, M.D.
• Stacey A Goodman Eaton, LCSW

• Marriage & Family Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.