Rosamond Ellis Goudeau, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

001410 Issued in GA

Practice address

179 Pierce Ave
Macon, GA 31204-2821

Phone

(478) 742-1464

Fax

(478) 742-1883

NPI assigned

Oct 6, 2006

Last updated

Jan 11, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Clinical Social Worker

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

MCG Eap Services IncGroup PAC ID 0749562619, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• MCG Eap Services, Inc.

  dba Southern Behavioral Services

  • Professional Counselor
  • Macon, GA
  • NPI 1700839735
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1467549790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 EMERY HIGHWAY",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31217",
            "telephone_number": "478-751-4446",
            "fax_number": "478-751-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 PIERCE AVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312042821",
            "telephone_number": "478-742-1464",
            "fax_number": "478-742-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUDEAU",
        "first_name": "ROSAMOND",
        "middle_name": "ELLIS",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "001410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "001410",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Destiny Renee Gordon, FNP-C
• Steven Emmett Gordon, DDS
• Ashwini Prabhakar Gore, M.D.
• Holly P Gore, NP-C
• Pramodini K Gosukonda, MD
• Nikki Govner, FNP
• Michelle Morton Gowan, R.PH.
• Kierra Grable
• Victoria Grabowski, CST, CSFA, AA-S
• Grace and Mercy Home Care

• Clinical Social Worker in Macon, GA
• Providers in Macon, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; 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.