Eboni Anicka Goldsby, N/A
Individual provider Active NPI Case Manager/Care Coordinator · Sterlington, LA
NPI 1124537642 · NPPES record last updated May 17, 2018
Key facts
- NPI
- 1124537642
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 506 Highway 2
Sterlington, LA 71280 - Phone
- (318) 598-5040
- Fax
- (844) 270-1958
- NPI assigned
- Sep 27, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Counseling, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
506 Highway 2
Sterlington, LA 71280
Mailing address
10649 Edgewood Dr
Bastrop, LA 71220-9685
Phone (318) 789-1978
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497113559 | Medicaid | LA |
Other providers in Sterlington, LA
- Richard Stewart Felkel
- Charline Foster
- Eldridge Franklin
- Aretha Fudge
- Shakyra Gibson
- Sara Doreen Grandy
- Paula Gray
- Benjamin Henderson
- Norma Hill
- Derrick Javan Hoard
All providers in Sterlington, LA · Case Manager/Care Coordinator in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.