Goodwill Industries of Fayette County

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

416340 Issued in PA

Legal business name

GOODWILL INDUSTRIES OF FAYETTE COUNTY

Practice address

690 W Main St
Uniontown, PA 15401-2648

Phone

(724) 439-9311

NPI assigned

Jan 10, 2007

Organization subpart

No

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

Authorized official

Name

Jacqueline Mitchell

Title

Vice President of Affiliate Operati

Phone

(724) 437-9878

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Goodwill Industries of Fayette County3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Goodwill Industries of Pittsburgh

  • Developmentally Disabled Services Day Training Agency
  • Pittsburgh, PA
  • NPI 1487796173
  NPD tax ID
• Goodwill of Southwestern Pennsylvania

  • Community/Behavioral Health Agency
  • Pittsburgh, PA
  • NPI 1740528413
  NPD tax ID

Locations

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194875682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 CONNELLSVILLE STREET",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "15401",
            "telephone_number": "724-437-9878",
            "fax_number": "724-437-9865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 W MAIN ST",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154012648",
            "telephone_number": "724-439-9311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODWILL INDUSTRIES OF FAYETTE COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "VICE PRESIDENT OF AFFILIATE OPERATI",
        "authorized_official_telephone_number": "724-437-9878"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "416340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUEOPTIONS PROVIDER NUM",
            "identifier": "472028",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roger A Goebel, MD
• Penelope Goldbach, LSW
• Jodilyn Golnik, LPC
• Mallory Gonzalez
• Good Works Life Recovery House
• Bailey Gordon
• Katherine Eileen Gosney, B.A.
• Gouker Chiropractic Clinic, P.C.
• Ronald E Gouker, DC CSCS CCSP
• Sigal Govrin

• Community/Behavioral Health Agency in Uniontown, PA
• Providers in Uniontown, PA by specialty
• Community/Behavioral Health Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.