Active NPI
Jeanimarie Goodwin
- Counselor
- Philadelphia, PA
National Provider Identifier
1558736769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 9815 Roosevelt Blvd
Suite B
Philadelphia, PA 19114-1035 - Phone
- (610) 644-6464
- Fax
- (610) 981-6078
- NPI assigned
- Dec 14, 2015
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
9815 Roosevelt Blvd
Suite B
Philadelphia, PA 19114-1035
Mailing address
680 American Ave
Suite 302
King of Prussia, PA 19406-4023
Phone (610) 644-6464
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life Management Inc | Past | Accepting new patients |
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.
-
- Mental Health Counselor
- Paoli, PA
- NPI 1992723969
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450051200000",
"number": "1558736769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "680 AMERICAN AVE",
"address_2": "SUITE 302",
"city": "KING OF PRUSSIA",
"state": "PA",
"postal_code": "194064023",
"telephone_number": "610-644-6464",
"fax_number": "610-981-6078"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9815 ROOSEVELT BLVD",
"address_2": "SUITE B",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191141035",
"telephone_number": "610-644-6464",
"fax_number": "610-981-6078"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODWIN",
"first_name": "JEANIMARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-12-14",
"last_updated": "2015-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.