Individual provider Active NPI

Ryan James Goettsch, LISW-S

  • Clinical Social Worker
  • Youngstown, OH
National Provider Identifier
1215485990
Registry record updated Sep 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2002435 Issued in OH
Practice address
725 Boardman Canfield Rd Ste M
Youngstown, OH 44512-4380
Phone
(330) 330-8655
NPI assigned
Sep 12, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.1610121-TRNE OH
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X I.2002435 OH Primary

Addresses

Primary practice location

725 Boardman Canfield Rd Ste M
Youngstown, OH 44512-4380

Mailing address

725 Boardman Canfield Rd Ste M
Boardman, OH 44512-4380
Phone (330) 402-9341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210203000855 OH Practitioner - Clinical Social Worker 7012321003 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Natura Behavioral Health LLCGroup PAC ID 7810350105, 16 clinicians
Rajendra P Koirala, M.D., LLCGroup PAC ID 8820334931, 23 clinicians

Practice addresses (Care Compare)

1207 W State St
Suite H
Alliance, OH 44601-4686
Phone (330) 798-0491

725 Boardman Canfield Rd
Suite L1
Boardman, OH 44512-4370
Phone (330) 330-8655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.1610121-TRNEOHMDSocial Worker
I.2002435OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Natura Behavioral Health LLC Single Specialty CurrentSince Jul 1, 2025 Accepting new patients
Comprehensive Behavioral Health Associates, Inc. Single Specialty CurrentSince Nov 15, 2020 Accepting new patients
Rajendra P Koirala, M.D., LLC Single Specialty CurrentSince Mar 1, 2023 Accepting new patients

Locations

1207 W State St
Ste H
Alliance, OH 44601
Phone (330) 206-1290

3768 Boardman Canfield Rd
Ste 5
Canfield, OH 44406
Phone (330) 798-0491

104 Javit Ct
Youngstown, OH 44515
Phone (330) 207-1754

7010 South Ave
Ste 2
Youngstown, OH 44512
Phone (330) 841-4976

725 Boardman Canfield Rd
Ste L1
Youngstown, OH 44512
Phone (330) 330-8655

725 Boardman Canfield Rd
Ste M
Youngstown, OH 44512
Phone (330) 330-8655

Organizations & group practices 4

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": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693785600000",
    "number": "1215485990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 BOARDMAN CANFIELD RD STE M",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124380",
            "telephone_number": "330-402-9341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 BOARDMAN CANFIELD RD STE M",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445124380",
            "telephone_number": "330-330-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOETTSCH",
        "first_name": "RYAN",
        "middle_name": "JAMES",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-12",
        "last_updated": "2023-09-04",
        "certification_date": "2023-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1610121-TRNE",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2002435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.