Jon Matthew Goudreau, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

108703 Issued in TX

Practice address

305 S Lucile St
Seattle, WA 98108-2435

Phone

(206) 764-5130

NPI assigned

Dec 6, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1225749773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 S LUCILE ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981082435",
            "telephone_number": "206-764-5130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 S LUCILE ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981082435",
            "telephone_number": "206-764-5130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUDREAU",
        "first_name": "JON",
        "middle_name": "MATTHEW",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "SA61356300",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "108703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen Frances Gottheil, M.D.
• Geoffrey Scott Gottlieb
• Greg Gottlieb
• Margot Gottschalk, MD
• Zachary Gottschalk
• Hisam Said Goueli, M.D.
• Frances Marie Gough, M.D.
• Kylie Jo Gough
• Alexander Gougoutas, MD
• Bernardo Haddock Lobo Goulart, MD, MS

• Social Worker in Seattle, WA
• Providers in Seattle, WA by specialty
• Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.