Individual provider Active NPI

Hallie Goodson

  • Mental Health Counselor
  • Tupelo, MS
National Provider Identifier
1275149197
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2434 S Eason Blvd
Tupelo, MS 38804-6942
Phone
(662) 640-4595
Fax
(662) 680-6416
NPI assigned
Sep 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2434 S Eason Blvd
Tupelo, MS 38804-6942

Mailing address

2434 S Eason Blvd
Tupelo, MS 38804-6942
Phone (662) 640-4595

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amerchant@lifecorehealthgroup.com

Medicare participation

Medicare enrollment files
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 Feb 24, 2026 through Feb 24, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1275149197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2434 S EASON BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388046942",
            "telephone_number": "662-640-4595",
            "fax_number": "662-680-6416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2434 S EASON BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388046942",
            "telephone_number": "662-640-4595",
            "fax_number": "662-680-6416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODSON",
        "first_name": "HALLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-16",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amerchant@lifecorehealthgroup.com",
            "affiliation": "N",
            "address_1": "2434 S Eason Blvd",
            "city": "Tupelo",
            "state": "MS",
            "country_code": "US",
            "postal_code": "388046942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.