Individual provider Active NPI

Melinda Jo Goodhead, BS

  • Counselor
  • Seattle, WA
National Provider Identifier
1164702296
Registry record updated Feb 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
CL60498380 Issued in WA
Practice address
10015 Lake City Way NE
441
Seattle, WA 98125-7770
Phone
(425) 244-1645
NPI assigned
Aug 21, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CL60498380 WA Primary

Addresses

Primary practice location

10015 Lake City Way NE
441
Seattle, WA 98125-7770

Mailing address

19815 50TH Ave W Apt G8
Lynnwood, WA 98036-6455
Phone (425) 244-1645

Other identifiers 1

IdentifierTypeStateIssuer
CL 60498380OtherWAWA STATE DEPT. OF HEALTH COUNSELOR CERTIFIED CERTIFICATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
CL60498380WAMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1313884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423785600000",
    "number": "1164702296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19815 50TH AVE W APT G8",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366455",
            "telephone_number": "425-244-1645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10015 LAKE CITY WAY NE",
            "address_2": "441",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981257770",
            "telephone_number": "425-244-1645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODHEAD",
        "first_name": "MELINDA",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "BS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-21",
        "last_updated": "2015-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CL60498380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE DEPT. OF HEALTH COUNSELOR CERTIFIED CERTIFICATION",
            "identifier": "CL 60498380",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; 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.