Shawanda Denise Goodman, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2025096570 Issued in MN

Practice address

4180 Thielman LN Ste 100
Saint Cloud, MN 56301-4692

Phone

(320) 281-3154

Fax

(833) 973-4798

NPI assigned

Aug 24, 2021

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• People Incorporated

  • Mental Illness Community Based Residential Treatment Facility
  • Minneapolis, MN
  • NPI 1376661447
  NPD (past)
• People Incorporated

  • Community/Behavioral Health Agency
  • Saint Paul, MN
  • NPI 1982722021
  NPD (past)

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1699442160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4180 THIELMAN LN STE 100",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014692",
            "telephone_number": "612-229-9421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4180 THIELMAN LN STE 100",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014692",
            "telephone_number": "320-281-3154",
            "fax_number": "833-973-4798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "SHAWANDA",
        "middle_name": "DENISE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-24",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "2025096570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raelyn Leona Gonnerman
• Jewelz Gonzalez
• Good Samaritan Assisted Living LLC
• Good to Geaux
• Christopher Marshall Goodman, M.D.
• William L Goodmanson, CRNA
• Charles Gordon
• Nicole Mary Gordon, RN
• Shawn Michael Gordon, RPH
• Tracy Gordon, LICSW

• Psychiatric/Mental Health Nurse Practitioner in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2026; 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.