Marissa I Goodman, LMHC, LPC, NCC, QS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH13655 Issued in FL

Practice address

1314 E Las Olas Blvd # 1606
Fort Lauderdale, FL 33301-2334

Phone

(754) 444-6486

NPI assigned

Apr 3, 2020

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1154950947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 E LAS OLAS BLVD",
            "address_2": "#1606",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33301",
            "telephone_number": "754-444-6486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 E LAS OLAS BLVD # 1606",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012334",
            "telephone_number": "754-444-6486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "MARISSA",
        "middle_name": "I",
        "credential": "LMHC, LPC, NCC, QS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH13655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Good Life ABA Therapy LLC
• Lindsay Good, PSYD
• Renee Patricia Gooden-Clarke, NP
• Goodman Drugs of FL Corp
• Jillian Goodman, SLP-CCC
• Amy Goodner
• Lindsay Goodnight, BCBA
• Lauren Audrey Goodson, ARNP
• Divyanjali Gopalan, MD
• Vladislav Gorbatiy, M.D.

• Mental Health Counselor in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.