Jennifer Goldade, LAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

90L-77-2089 Issued in ND

Practice address

1237 W Divide Ave
Ste 5
Bismarck, ND 58501-1208

Phone

(701) 328-8888

Fax

(701) 328-8900

NPI assigned

May 30, 2012

Last updated

May 30, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338336000000",
    "number": "1235490970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 W DIVIDE AVE",
            "address_2": "STE 5",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011208",
            "telephone_number": "701-328-8888",
            "fax_number": "701-328-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 W DIVIDE AVE",
            "address_2": "STE 5",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011208",
            "telephone_number": "701-328-8888",
            "fax_number": "701-328-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDADE",
        "first_name": "JENNIFER",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-30",
        "last_updated": "2012-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ND",
            "license": "90L-77-2089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Addiction (Substance Use Disorder) Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2012; 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.