Samantha Kaye Goodwin

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

257688 Issued in KY

Practice address

125 S Main Cross St
Louisa, KY 41230-1065

Phone

(606) 638-0938

NPI assigned

Feb 25, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY, IN2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Chronic Illness Counseling Center LLC

  • Clinical Social Worker
  • Louisville, KY
  • NPI 1548839285
  Medicare reassignment NPD
• Auxilium Psychological Services, LLC

  • Psychologist
  • New Albany, IN
  • NPI 1649787565
  Medicare reassignment NPD

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

{
    "created_epoch": "1645747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1407502602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S MAIN CROSS ST",
            "city": "LOUISA",
            "state": "KY",
            "postal_code": "412301065",
            "telephone_number": "606-638-0938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S MAIN CROSS ST",
            "city": "LOUISA",
            "state": "KY",
            "postal_code": "412301065",
            "telephone_number": "606-638-0938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "SAMANTHA",
        "middle_name": "KAYE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-25",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "254526",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "257688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juanita Goble
• Brandon Goins
• John Christopher Goins, PSS
• Stephanie Brooke Golden, PHARMD
• Charlotte Gale Goodrum
• Charles Jamison Graham, PSS
• Sarah Gray
• Shannon Kristian Gray
• Vicki Lynne Gray, LCADC
• George Green

• Clinical Social Worker in Louisa, KY
• Providers in Louisa, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.