Individual provider Active NPI

December L Goad, LPC

  • Mental Health Counselor
  • Savannah, GA
National Provider Identifier
1508105289
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC009595 Issued in GA
Practice address
50 Al Henderson Blvd
Savannah, GA 31419-6001
Phone
(912) 417-5787
NPI assigned
Jan 31, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X
Mental Health Counselor 101YM0800X 102156 KY
Mental Health Counselor 101YM0800X LPC009595 GA Primary

Addresses

Primary practice location

50 Al Henderson Blvd
Savannah, GA 31419-6001

Mailing address

4217 Accomack Dr
Louisville, KY 40241-1829
Phone (914) 417-5787

Other practice location 1

4217 Accomack Dr
Louisville, KY 40241-1829
Phone (912) 441-7578

Other identifiers 1

IdentifierTypeStateIssuer
7100298630MedicaidKY

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

State licenses

LicenseStateTypeSpecialty
LPC009595GAMDMental Health Counselor
102156KYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
DG Counseling LLC Mental Health Current Accepting new patients

Locations

50 Al Henderson Blvd
Savannah, GA 31419
Phone (912) 200-6643

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": "1359590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1508105289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4217 ACCOMACK DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402411829",
            "telephone_number": "914-417-5787",
            "fax_number": "855-951-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 AL HENDERSON BLVD",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314196001",
            "telephone_number": "912-417-5787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4217 Accomack Dr",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402411829",
            "country_code": "US",
            "telephone_number": "912-441-7578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOAD",
        "first_name": "DECEMBER",
        "middle_name": "L",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-31",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "102156",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC009595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100298630",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.