Nektaria Goudis, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.009199 Issued in IL

Practice address

308 S. Jefferson Street
#127
Chicago, IL 60661

Phone

(312) 766-8685

Fax

(312) 872-8183

NPI assigned

Dec 29, 2015

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

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.

Opted out of Medicare

Yes, effective Nov 20, 2017 through Nov 20, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dr Susan B Myket PC

  dba Susan Myket, PH.D. & Associates

  • Clinical Psychologist
  • Naperville, IL
  • NPI 1457570251
  NPD (past)

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

{
    "created_epoch": "1451347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1255796611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 LEE STREET",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "60016",
            "telephone_number": "224-725-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 S. JEFFERSON STREET",
            "address_2": "#127",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60661",
            "telephone_number": "312-766-8685",
            "fax_number": "312-872-8183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUDIS",
        "first_name": "NEKTARIA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-29",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Alan Gottschalk, ND, FNP
• Bridgette Gottwald, LPC
• Catherine Gotz, APN
• Bishoy Nabil Nicolas Goubran, MD
• Louis B. Goudanis, D.D.S.
• Emily Gouger
• Ian Broderick Gough, MS, LPC
• Andrew Gould
• Elizabeth M. Gould, NP
• Jaclyn Michelle Gould

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.