Individual provider Active NPI

Cherjuan Yvette Goodman, LPC, CRC

  • Counselor
  • Oklahoma City, OK
National Provider Identifier
1588047237
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6917 Issued in OK
Practice address
4130 N Lincoln Blvd
Oklahoma City, OK 73105-5209
Phone
(405) 424-7711
NPI assigned
Jun 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPC CANDIDATE OK
Counselor 101Y00000X 6917 OK Primary

Addresses

Primary practice location

4130 N Lincoln Blvd
Oklahoma City, OK 73105-5209

Mailing address

5104 NE 38TH St
Oklahoma City, OK 73121-6409
Phone (405) 514-6893

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20250924004875 OK Practitioner - Mental Health Counselor 7618472234 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4400 M Lincoln Blvd
Oklahoma City, OK 73105-5108

5801 Braodway Ext Hwy
Suite 210
Oklahoma City, OK 73105-5108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC CANDIDATEOKMDCounselor
6917OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Mental Health Council CurrentSince Jul 1, 2025 Accepting new patients
Oklahoma Mental Health Council CurrentSince Jul 1, 2025 Accepting new patients

Locations

4130 N Lincoln Blvd
Oklahoma City, OK 73105
Phone (405) 267-3246

4400 N Lincoln Blvd
Oklahoma City, OK 73105

Organizations & group practices 2

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": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1588047237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5104 NE 38TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731216409",
            "telephone_number": "405-514-6893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 N LINCOLN BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731055209",
            "telephone_number": "405-424-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "CHERJUAN",
        "middle_name": "YVETTE",
        "credential": "LPC, CRC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-30",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": "LPC CANDIDATE",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": "6917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.