Individual provider Active NPI

Jodi Good, LSW

  • Clinical Social Worker
  • Lancaster, PA
National Provider Identifier
1366042350
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW022271 Issued in PA
Practice address
1902 Olde Homestead LN
Lancaster, PA 17601-5875
Phone
(717) 390-0353
Fax
(717) 390-1812
NPI assigned
Oct 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW134751 PA
Clinical Social Worker 1041C0700X CW022271 PA Primary

Addresses

Primary practice location

1902 Olde Homestead LN
Lancaster, PA 17601-5875

Mailing address

PO Box 597
Mountville, PA 17554-0597
Phone (717) 285-7121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20211213002829 PA Practitioner - Clinical Social Worker 1153711767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Services Group IncGroup PAC ID 1052201571, 32 clinicians

Practice addresses (Care Compare)

1902 Olde Homestead Lane
Lancaster, PA 17601-5824
Phone (717) 390-0353

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW134751PAMDSocial Worker
CW022271PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Services Group, Inc. CurrentSince Oct 27, 2021 Accepting new patients

Locations

989 E Park Dr
Harrisburg, PA 17111
Phone (717) 564-4521

1902 Olde Homestead Ln
Lancaster, PA 17601
Phone (717) 285-7121

320 Highland Dr
Mountville, PA 17554
Phone (717) 285-7121

1000 Commerce Park Dr
Ste 110
Williamsport, PA 17701
Phone (570) 323-6944

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": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1366042350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 597",
            "city": "MOUNTVILLE",
            "state": "PA",
            "postal_code": "175540597",
            "telephone_number": "717-285-7121",
            "fax_number": "717-285-5302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 OLDE HOMESTEAD LN",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176015875",
            "telephone_number": "717-390-0353",
            "fax_number": "717-390-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOD",
        "first_name": "JODI",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-28",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW134751",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW022271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.