Goolsbys Clinical Services, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH12309 Issued in FL

Legal business name

GOOLSBYS CLINICAL SERVICES, LLC

Practice address

2720 Park St Ste 202
Jacksonville, FL 32205-7645

Phone

(904) 338-2998

Fax

(844) 250-8734

NPI assigned

Mar 22, 2018

Last updated

Mar 22, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kevin GoolsbyNPI 1235350562

Title

Owner

Phone

(904) 338-2998

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin Goolsby, M.A., LMHC, NCC

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1235350562
  NPD Authorized official
• Tiffany Nicole Keller-Goolsby, MA

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1376779157
  NPD

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521676800000",
    "number": "1174027130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9233 REDTAIL DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322222811",
            "telephone_number": "904-338-2998",
            "fax_number": "844-250-8734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 PARK ST STE 202",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322057645",
            "telephone_number": "904-338-2998",
            "fax_number": "844-250-8734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOLSBYS CLINICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-22",
        "last_updated": "2018-03-22",
        "status": "A",
        "authorized_official_last_name": "GOOLSBY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-338-2998"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH12309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "768184400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Googe
• Michael Prince Goold, MD
• Ruphlal Robert Gooljar
• Kevin Goolsby, M.A., LMHC, NCC
• Shannon Richards Goolsby
• Shannon Page Goossen, AP, LMT
• Gopal Pharmacy LLC (Mandarin Pharmacy)
• Neethu Gopal, MBBS
• Rajesh Gopal, M.D.
• Vikram Devegowda Gopal, MD

• Mental Health Counselor in Jacksonville, FL
• Providers in Jacksonville, 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 22, 2018; 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.