Individual provider Active NPI

Carolyn B Goldsmith, EDD LPC-S LMFT-S

  • Counselor
  • Fort Worth, TX
National Provider Identifier
1306854161
Registry record updated Apr 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
9603 Issued in TX
Practice address
6410 Southwest Blvd
Suite 230
Fort Worth, TX 76109
Phone
(817) 292-8500
Fax
(817) 370-1068
NPI assigned
Aug 4, 2006
Last updated
Apr 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 9603 TX Primary
Counselor 101Y00000X 703 TX

Addresses

Primary practice location

6410 Southwest Blvd
Suite 230
Fort Worth, TX 76109

Mailing address

6410 Southwest Blvd
Suite 230
Fort Worth, TX 76109
Phone (817) 292-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240108005199 TX Practitioner - Mental Health Counselor 3870944457 Practice locations: Benbrook, TX

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6410 Southwest Blvd
Suite 230
Benbrook, TX 76109-6920
Phone (817) 292-8500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9603TXMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1306854161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 SOUTHWEST BLVD",
            "address_2": "SUITE 230",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76109",
            "telephone_number": "817-292-8500",
            "fax_number": "817-370-1068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 SOUTHWEST BLVD",
            "address_2": "SUITE 230",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76109",
            "telephone_number": "817-292-8500",
            "fax_number": "817-370-1068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSMITH",
        "first_name": "CAROLYN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "EDD LPC-S LMFT-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "9603",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "703",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.