Jennifer Marie Gottfried, PCC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.0700864 Issued in OH

Practice address

6797 N High St Ste 223
Worthington, OH 43085-2533

Phone

(419) 704-7358

NPI assigned

Sep 27, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Mental Health Counselor

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Group practices

Secure Haven Behavioral Health Care IncGroup PAC ID 3678939121, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Secure Haven Behavioral Health Care Inc

  • Community/Behavioral Health Agency
  • Westerville, OH
  • NPI 1871173880
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1588947352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16775 TEXAS RD SE",
            "city": "HEATH",
            "state": "OH",
            "postal_code": "430569410",
            "telephone_number": "419-704-7358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6797 N HIGH ST STE 223",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430852533",
            "telephone_number": "419-704-7358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTFRIED",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PCC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-27",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.0700864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Joseph Goodman
• Brooklyn Goodson, M.ED.
• Tami Jo Gordon, LPTA
• Katelind Gorman
• David Albert Goss Jr., DO
• Andrew Gotthardt
• Joseph Leonard Govern
• Tim Graham, M.A., LPC, CHWC
• Paul Frances Granello, PH.D.
• Hannah Gray

• Professional Counselor in Worthington, OH
• Providers in Worthington, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; 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.