Active NPI
Sherry Terease Goosby
- Counselor
- Detroit, MI
National Provider Identifier
1649501131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 6401012425
- Practice address
- 3737 Lawton St
Detroit, MI 48208-2500 - Phone
- (313) 361-6136
- Fax
- (313) 361-6211
- NPI assigned
- Jan 22, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6401012425 | MI | Primary |
Addresses
Primary practice location
3737 Lawton St
Detroit, MI 48208-2500
Mailing address
3737 Lawton St
Detroit, MI 48208-2500
Phone (313) 361-6136
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649501131 | Other | MI | CLINICAL THERAPIST |
Other names 1
- Sherry Terease Goosby
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401012425 | MI | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355356800000",
"number": "1649501131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3737 LAWTON ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482082500",
"telephone_number": "313-361-6136",
"fax_number": "313-361-6211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3737 LAWTON ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482082500",
"telephone_number": "313-361-6136",
"fax_number": "313-361-6211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOOSBY",
"first_name": "SHERRY",
"middle_name": "TEREASE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-22",
"last_updated": "2012-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "6401012425",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLINICAL THERAPIST",
"identifier": "1649501131",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SHERRY",
"last_name": "GOOSBY",
"middle_name": "TEREASE",
"credential": "MA, LLPC",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.