Koa Celeste Goode, LCSWA
Individual provider Active NPI Clinical Social Worker · Locust, NC
NPI 1609630474 · NPPES record last updated Feb 12, 2024
Key facts
- NPI
- 1609630474
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- P019028 (NC)
- Practice address
- 8839 Cornwall St
Locust, NC 28097-9533 - Phone
- (978) 397-8874
- NPI assigned
- Feb 12, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P019028 | NC | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P019028 | NC | Yes |
Addresses
Primary practice location
8839 Cornwall St
Locust, NC 28097-9533
Mailing address
8839 Cornwall St
Locust, NC 28097-9533
Phone (978) 397-8874
Other providers in Locust, NC
- DRS. Martin and Brune, PLLC
- Janna Kristen Featherstone
- Donna Smith Fesperman
- First Care Medical Clinic
- Dana Blanton Foster
- Janet Gordon
- Joshua Randal Hall
- Angela D Hamby
- Jan Gail Hardcopf -Bickley
- Tessa Ann Hartsell
All providers in Locust, NC · Clinical Social Worker in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.