Active NPI
Kimberly Goodson
- Community Health Worker
- Redford, MI
National Provider Identifier
1437665189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- Lincoln Behavioral Services
9315 Telegraph Road
Redford, MI 48239 - Phone
- (313) 450-4500
- NPI assigned
- Dec 18, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | MI | Primary |
Addresses
Primary practice location
Lincoln Behavioral Services
9315 Telegraph Road
Redford, MI 48239
Mailing address
Lincoln Behavioral Services
9315 Telegraph Road
Redford, MI 48239
Phone (313) 450-4500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P613469067450 | Medicaid | MI |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649289600000",
"number": "1437665189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "LINCOLN BEHAVIORAL SERVICES",
"address_2": "9315 TELEGRAPH ROAD",
"city": "REDFORD",
"state": "MI",
"postal_code": "48239",
"telephone_number": "313-450-4500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "LINCOLN BEHAVIORAL SERVICES",
"address_2": "9315 TELEGRAPH ROAD",
"city": "REDFORD",
"state": "MI",
"postal_code": "48239",
"telephone_number": "313-450-4500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODSON",
"first_name": "KIMBERLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-18",
"last_updated": "2022-04-07",
"certification_date": "2022-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Community Health Worker",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "P613469067450",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Redford, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.