Active NPI
Jeanette Anderson Good, LPC PHD
- Pastoral Counselor
- South Portland, ME
National Provider Identifier
1629264452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- License
- LP 2072
- Practice address
- 884 Broadway
South Portland, ME 04106 - Phone
- (207) 767-1165
- NPI assigned
- Sep 14, 2007
- 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 |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | LP 2072 | ME | Primary |
Addresses
Primary practice location
884 Broadway
South Portland, ME 04106
Mailing address
146 W Grand Avenue
Ocean Park Meadows #24
Old Orchard Beach, ME 04064
Phone (207) 934-9882
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP 2072 | ME | MD | Pastoral Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189728000000",
"number": "1629264452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "146 W GRAND AVENUE",
"address_2": "OCEAN PARK MEADOWS #24",
"city": "OLD ORCHARD BEACH",
"state": "ME",
"postal_code": "04064",
"telephone_number": "207-934-9882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "884 BROADWAY",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "04106",
"telephone_number": "207-767-1165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOOD",
"first_name": "JEANETTE",
"middle_name": "ANDERSON",
"name_prefix": "Dr.",
"credential": "LPC PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-14",
"last_updated": "2007-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "ME",
"license": "LP 2072",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.