Individual provider Active NPI

Cassandra Latrice Goldsmith

  • Addiction (Substance Use Disorder) Counselor
  • Greenville, SC
National Provider Identifier
1326710641
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
570542729 Issued in SC
Practice address
130 Industrial Dr
Greenville, SC 29607-3241
Phone
(864) 467-3790
Fax
(864) 467-3765
NPI assigned
Oct 5, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 570542729 SC Primary

Addresses

Primary practice location

130 Industrial Dr
Greenville, SC 29607-3241

Mailing address

803 Bindon LN
Simpsonville, SC 29680-7327
Phone (864) 467-3732

Other identifiers 1

IdentifierTypeStateIssuer
570542729MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
570542729SCMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1326710641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 BINDON LN",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296807327",
            "telephone_number": "864-467-3732",
            "fax_number": "864-467-3765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 INDUSTRIAL DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073241",
            "telephone_number": "864-467-3790",
            "fax_number": "864-467-3765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSMITH",
        "first_name": "CASSANDRA",
        "middle_name": "LATRICE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "SC",
            "license": "570542729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "570542729",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.