Active NPI
Johanna Evelyn Goossen, LGSW
- Counselor
- Apple Valley, MN
National Provider Identifier
1225864408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 17392
- Practice address
- 7300 147TH St W Ste 600
Apple Valley, MN 55124-7850 - Phone
- (952) 997-3020
- NPI assigned
- Sep 12, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 17392 | MN | Primary |
Addresses
Primary practice location
7300 147TH St W Ste 600
Apple Valley, MN 55124-7850
Mailing address
7300 147TH St W Ste 600
Apple Valley, MN 55124-7850
Phone (952) 997-3020
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17392 | MN | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nystrom & Associates, LTD | Current | Accepting new patients | |
| Family Support Services Inc. | Past | Accepting new patients |
Locations
7300 147th St W
Ste 600
Apple Valley, MN 55124
Phone (952) 997-3020
Organizations & group practices 2
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.
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- New Brighton, MN
- NPI 1396750188
-
- Mental Health Counselor
- New Brighton, MN
- NPI 1467549220
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726099200000",
"number": "1225864408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7300 147TH ST W STE 600",
"city": "APPLE VALLEY",
"state": "MN",
"postal_code": "551247850",
"telephone_number": "952-997-3020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7300 147TH ST W STE 600",
"city": "APPLE VALLEY",
"state": "MN",
"postal_code": "551247850",
"telephone_number": "952-997-3020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOOSSEN",
"first_name": "JOHANNA",
"middle_name": "EVELYN",
"credential": "LGSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-12",
"last_updated": "2024-09-12",
"certification_date": "2024-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MN",
"license": "17392",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Apple Valley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.