Nancy Gogolakis, MS, LPCC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC02650 Issued in MN

Practice address

2524 Golden Valley Pkwy S
Fargo, ND 58104-7355

Phone

(701) 403-4759

NPI assigned

Feb 2, 2022

Last updated

Feb 2, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Radiant Healthcare Services LLC

  • Community/Behavioral Health Agency
  • Edina, MN
  • NPI 1295597391
  Medicare reassignment NPD

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

{
    "created_epoch": "1643760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1225781966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2524 GOLDEN VALLEY PKWY S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2524 GOLDEN VALLEY PKWY S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047355",
            "telephone_number": "701-403-4759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOGOLAKIS",
        "first_name": "NANCY",
        "credential": "MS, LPCC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-02",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC02650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Goerke
• Sarah Goerts
• Goetz Mental Wellness Initiative (Imagine Thriving)
• Jennifer S Goetz, LRD
• Akshay Gogna, MD
• Joann Gohl
• Jacob A Goldenberg, MD
• Linda S Goldstone, CCC-SLP
• Rebecca Goltz
• Brock Gomer, PT, DPT, ATC

• Professional Counselor in Fargo, ND
• Providers in Fargo, ND by specialty
• Professional Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.