Individual provider Active NPI

Rachel Bannert-Goddu, LPC

  • Mental Health Counselor
  • Rogers, AR
National Provider Identifier
1205249976
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P2002017 Issued in AR
Practice address
1207 W Poplar St
Rogers, AR 72756-4245
Phone
(479) 310-5640
NPI assigned
Jun 10, 2014
Last updated
Dec 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P2002017 AR Primary
Professional Counselor 101YP2500X P2002017 AR

Addresses

Primary practice location

1207 W Poplar St
Rogers, AR 72756-4245

Mailing address

PO Box 155
Rogers, AR 72757-0155
Phone (479) 310-5640

Other practice location 1

5500 W Pinnacle Pointe Dr Ste 204
Rogers, AR 72758-8153
Phone (479) 268-4142

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
P2002017ARMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sharon Nelson Counseling Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1205249976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727570155",
            "telephone_number": "479-310-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 W POPLAR ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727564245",
            "telephone_number": "479-310-5640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5500 W Pinnacle Pointe Dr Ste 204",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727588153",
            "country_code": "US",
            "telephone_number": "479-268-4142",
            "fax_number": "888-732-7108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANNERT-GODDU",
        "first_name": "RACHEL",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-10",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P2002017",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P2002017",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; 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.