Good-Elliott Counseling, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

340004467A Issued in IN

Legal business name

GOOD-ELLIOTT COUNSELING, LLC

Practice address

313 S 3Rd St
Goshen, IN 46526-3709

Phone

(574) 535-0880

Fax

(574) 535-0882

NPI assigned

Mar 27, 2018

Last updated

Mar 27, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Philip David Good-Elliott, MSW, LCSWNPI 1033126446

Title

Owner

Phone

(574) 535-0880

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Philip David Good-Elliott, LCSW

  • Clinical Social Worker
  • Goshen, IN
  • NPI 1033126446
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522108800000",
    "number": "1659876126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 S 3RD ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465263709",
            "telephone_number": "574-535-0880",
            "fax_number": "574-535-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 S 3RD ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465263709",
            "telephone_number": "574-535-0880",
            "fax_number": "574-535-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD-ELLIOTT COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-27",
        "last_updated": "2018-03-27",
        "status": "A",
        "authorized_official_last_name": "GOOD-ELLIOTT",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-535-0880",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "IN",
            "license": "340004467A",
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "IN",
            "license": "34004467A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniela Gomez-Miller
• Becky Gomez
• Brittany Christine Gongwer, MSN, BSN
• Annette Gonzales
• Good to Grow Dental Center, PLLC
• Philip David Good-Elliott, LCSW
• Amy Justine Goodrich, RD, IBCLC
• Heather Gorball, MSW
• Goshen Ambulatory Care Center LLC
• Goshen Anesthesiology LLC

• Adult Mental Health Clinic/Center in Goshen, IN
• Providers in Goshen, IN by specialty
• Adult Mental Health Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.