Individual provider Active NPI

Jamilla Goins, MS, SAC, LPC-IT

  • Professional Counselor
  • New Richmond, WI
National Provider Identifier
1336732643
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4749-226 Issued in WI
Practice address
150 W 1St St Ste 270
New Richmond, WI 54017-1770
Phone
(715) 246-4840
Fax
(715) 254-9459
NPI assigned
Feb 17, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4749-226 WI Primary

Addresses

Primary practice location

150 W 1St St Ste 270
New Richmond, WI 54017-1770

Mailing address

150 W 1St St Ste 270
New Richmond, WI 54017-1770
Phone (715) 246-4840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20250220002652 WI Practitioner - Mental Health Counselor 9739609736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Therapy Associates LLCGroup PAC ID 5395273536, 28 clinicians

Practice addresses (Care Compare)

150 W 1St St
Suite 270
New Richmond, WI 54017-1770
Phone 7152464840131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4749-226WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Therapy Associates, LLC CurrentSince Feb 13, 2025 Accepting new patients

Locations

2010 Oneil Rd
Ste E
Hudson, WI 54016

150 W 1st St
Ste 270
New Richmond, WI 54017
Phone 7152464840130

Organizations & group practices 1

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": "1613520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1336732643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W 1ST ST STE 270",
            "city": "NEW RICHMOND",
            "state": "WI",
            "postal_code": "540171770",
            "telephone_number": "715-246-4840",
            "fax_number": "715-254-9459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W 1ST ST STE 270",
            "city": "NEW RICHMOND",
            "state": "WI",
            "postal_code": "540171770",
            "telephone_number": "715-246-4840",
            "fax_number": "715-254-9459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOINS",
        "first_name": "JAMILLA",
        "credential": "MS, SAC, LPC-IT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4749-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Richmond, WI

Sources for this page

Verify at the official NPI Registry.