Jessica Y Goodman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

067458 Issued in NY

Practice address

252 James St
Fairfield, CT 06824-6475

Phone

(917) 623-7765

Fax

(917) 210-3426

NPI assigned

May 6, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Jyg Counseling Services, LLC

  • Clinical Social Worker
  • Fairfield, CT
  • NPI 1598138398

  FL

  Medicare reassignment Authorized official
• Total Life Inc.

  • Group Psychotherapy Psychologist
  • Jupiter, FL
  • NPI 1053909267
  Medicare reassignment NPD

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

{
    "created_epoch": "1273104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450396800000",
    "number": "1295053908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 JAMES ST",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "06824",
            "telephone_number": "917-623-7765",
            "fax_number": "917-210-3426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 JAMES ST",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246475",
            "telephone_number": "917-623-7765",
            "fax_number": "917-210-3426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "JESSICA",
        "middle_name": "Y",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-06",
        "last_updated": "2015-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "067458",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "007879",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Gomola, MS, CCC-SLP
• Michelle Goncalves, APRN
• Anda Raluca Gonciulea, M.D
• Andrea Marion Goodman, MSW, LCSW
• Cary K Goodman, PH.D.
• Dorota Gorczynska
• Mackenzie Gordon, RDN
• Ram Y. Gordon, MD
• Ian Gorovoy, M.D.
• Marianne Gorski

• Clinical Social Worker in Fairfield, CT
• Providers in Fairfield, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.