Individual provider Active NPI

Melinda Ann Goodwin, LCSW, CSAC

  • Clinical Social Worker
  • Doylestown, PA
National Provider Identifier
1205113602
Registry record updated Aug 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW017281 Issued in PA
Practice address
11 Weldon Dr
Doylestown, PA 18901-2359
Phone
(215) 345-8530
Fax
(215) 345-5423
NPI assigned
Nov 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0710102630 VA
Clinical Social Worker 1041C0700X 0904007355 VA
Clinical Social Worker 1041C0700X CW017281 PA Primary

Addresses

Primary practice location

11 Weldon Dr
Doylestown, PA 18901-2359

Mailing address

11 Weldon Dr
Doylestown, PA 18901-2359
Phone (215) 345-8530

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

State licenses

LicenseStateTypeSpecialty
0710102630VAMDAddiction (Substance Use Disorder) Counselor
CW017281PAMDClinical Social Worker
0904007355VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ruggiero Investments, LLC CurrentSince Jul 1, 2023 Accepting new patients
Aldie Foundation Past Accepting new patients
Aldie Foundation Past Accepting new patients

Locations

2288 2nd Street Pike
Ste 1
Newtown, PA 18940
Phone (215) 309-6003

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1205113602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 WELDON DR",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189012359",
            "telephone_number": "215-345-8530",
            "fax_number": "215-345-5423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 WELDON DR",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189012359",
            "telephone_number": "215-345-8530",
            "fax_number": "215-345-5423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "MELINDA",
        "middle_name": "ANN",
        "credential": "LCSW, CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-14",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0710102630",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007355",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doylestown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.