Krystalyn Goode, SAC-IT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

18439-130

Practice address

2625 N Weil Street
Milwaukee, WI 53212

Phone

(414) 962-1200

Fax

(414) 962-2305

NPI assigned

Jun 28, 2018

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1639664923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 N WEIL STREET",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532123060",
            "telephone_number": "414-962-1200",
            "fax_number": "414-962-2305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 N WEIL STREET",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53212",
            "telephone_number": "414-962-1200",
            "fax_number": "414-962-2305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODE",
        "first_name": "KRYSTALYN",
        "name_prefix": "Ms.",
        "credential": "SAC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-28",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": "18439-130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Good Land Dental Mke, LLC
• Good Vibes Family Care Company, LLC
• Ashley Good, RN-BSN; DNP-FNP
• Susan Erickson Good, M.D.
• Elizabeth Goodbody
• Karin Scheftner Goodfriend, MD
• Rosie E Goodhue, D.O.
• Berrit Harriet Estelle Goodman, OTR/L
• Joseph Jay Goodman, MD
• Judith A Goodman, MS

• Addiction (Substance Use Disorder) Counselor in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.