Kevin Goolsby, M.A., LMHC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH12309 Issued in FL

Practice address

2720 Park Street Ste 202
Jacksonville, FL 32222-3810

Phone

(904) 338-2998

NPI assigned

May 2, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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 and National Provider Directory roles.

• Goolsbys Clinical Services, LLC

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1174027130
  NPD Authorized official

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1235350562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9233 REDTAIL DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322222811",
            "telephone_number": "904-338-2998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 PARK STREET STE 202",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322223810",
            "telephone_number": "904-338-2998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOLSBY",
        "first_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "M.A., LMHC, NCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH12309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "768184400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Phillips Goodwin, CRNA
• Sheri Anne Goodwin, MSC.
• Kelly Googe
• Michael Prince Goold, MD
• Ruphlal Robert Gooljar
• Shannon Richards Goolsby
• Goolsbys Clinical Services, LLC
• Shannon Page Goossen, AP, LMT
• Gopal Pharmacy LLC
• Neethu Gopal, MBBS

• Mental Health Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; 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.