Individual provider Active NPI

Elizabeth J Goodall, PC

  • Mental Health Counselor
  • Yellow Springs, OH
National Provider Identifier
1417201765
Registry record updated Feb 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C-1100497 Issued in OH
Practice address
416 Xenia Ave
Yellow Springs, OH 45387-1836
Phone
(937) 767-9171
Fax
(937) 767-9171
NPI assigned
Nov 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C-1100497 OH Primary

Addresses

Primary practice location

416 Xenia Ave
Yellow Springs, OH 45387-1836

Mailing address

416 Xenia Ave
Yellow Springs, OH 45387-1836
Phone (937) 767-9171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240103001471 OH Practitioner - Mental Health Counselor 6204286255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Layh and Associates IncGroup PAC ID 0749266591, 15 clinicians

Practice addresses (Care Compare)

416 Xenia Ave
Yellow Springs, OH 45387-1836
Phone (937) 767-9171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C-1100497OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Layh & Associates Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

416 Xenia Ave
Yellow Springs, OH 45387
Phone (937) 767-9171

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": "1352246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1417201765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 XENIA AVE",
            "city": "YELLOW SPRINGS",
            "state": "OH",
            "postal_code": "453871836",
            "telephone_number": "937-767-9171",
            "fax_number": "937-767-9175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 XENIA AVE",
            "city": "YELLOW SPRINGS",
            "state": "OH",
            "postal_code": "453871836",
            "telephone_number": "937-767-9171",
            "fax_number": "937-767-9171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODALL",
        "first_name": "ELIZABETH",
        "middle_name": "J",
        "credential": "PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-07",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C-1100497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yellow Springs, OH

Sources for this page

Verify at the official NPI Registry.