Individual provider Active NPI

Molly Mary Goodman, BSW, MSW, SSW

  • Social Worker
  • Peoria, IL
National Provider Identifier
1679447007
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
7820 N University St Ste 101
Peoria, IL 61614-8301
Phone
(309) 253-2471
NPI assigned
Sep 30, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X IL Primary

Addresses

Primary practice location

7820 N University St Ste 101
Peoria, IL 61614-8301

Mailing address

17868 Township Road 500 N
Wyoming, IL 61491-8939
Phone (309) 883-2405

Other names 1

  • Molly Mary Carlton Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1759190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1679447007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17868 TOWNSHIP ROAD 500 N",
            "city": "WYOMING",
            "state": "IL",
            "postal_code": "614918939",
            "telephone_number": "309-883-2405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7820 N UNIVERSITY ST STE 101",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148301",
            "telephone_number": "309-253-2471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "MOLLY",
        "middle_name": "MARY",
        "credential": "BSW, MSW, SSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-30",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "CARLTON",
            "middle_name": "MARY",
            "credential": "BSW, MSW, SSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; 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.