Individual provider Active NPI

Heather R Goudy, CT

  • Counselor
  • Dayton, OH
National Provider Identifier
1295348514
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
C.2002614-TRNE Issued in OH
Practice address
601 S Edwin C Moses Blvd
Dayton, OH 45417-3424
Phone
(937) 734-8333
NPI assigned
Aug 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X C.2002614-TRNE OH Primary

Addresses

Primary practice location

601 S Edwin C Moses Blvd
Dayton, OH 45417-3424

Mailing address

601 S Edwin C Moses Blvd
Dayton, OH 45417-3424
Phone (937) 734-8333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20240116003149 OH Practitioner - Mental Health Counselor 0042662926 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

601 S Edwin C Moses Blvd
Dayton, OH 45417-3424
Phone (937) 734-8333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.2002614-TRNEOHMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Behavioral Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Samaritan Behavioral Health, Inc. Current Accepting new patients
New Chapter Counseling LLC Current Accepting new patients
Samaritan Behavioral Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Grow Healthcare Group PA CurrentSince Jun 25, 2025 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

4449 Easton Way
Fl 2
Columbus, OH 43219
Phone (614) 565-8197

601 S Edwin C Moses Blvd
Dayton, OH 45417
Phone (937) 734-4310

601 S Edwin C Moses Blvd
Fl 4
Dayton, OH 45417
Phone (937) 734-8333

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/sbhihelp/r4/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1295348514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S EDWIN C MOSES BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173424",
            "telephone_number": "937-734-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S EDWIN C MOSES BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173424",
            "telephone_number": "937-734-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUDY",
        "first_name": "HEATHER",
        "middle_name": "R",
        "credential": "CT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-26",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "C.2002614-TRNE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.