Mitchell Benjamin Gooch

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

068.0134196 Issued in VT

Practice address

2580 Chuckanut St
Eugene, OR 97408-7327

Phone

(503) 269-4979

NPI assigned

Jun 26, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Orchard Counseling, LLC

  • Mental Health Counselor
  • Eugene, OR
  • NPI 1760053219

  VT

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1134569890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 CHUCKANUT ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974087327",
            "telephone_number": "503-269-4979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 CHUCKANUT ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974087327",
            "telephone_number": "503-269-4979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39 McIntosh Ave",
            "address_purpose": "LOCATION",
            "city": "South Burlington",
            "state": "VT",
            "postal_code": "054037375",
            "country_code": "US",
            "telephone_number": "503-269-4979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOOCH",
        "first_name": "MITCHELL",
        "middle_name": "BENJAMIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-26",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "068.0134196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Elizabeth Gonzalez, LMT
• Oscar Jesus Gonzalez
• Gonzalo Camp LCSW LLC
• Norman M Goo, OD
• Aislynn Estelle Gooch
• Good Neighbor Care Eugene, LLC
• Sara Leeann Goodman, LMT
• Shanon Goodpasture-Lehr
• Jennifer Jean Goodrich, DO
• Jacob Goodspeed

• Mental Health Counselor in Eugene, OR
• Providers in Eugene, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.