Jacqueline Marie Goddard
Individual provider Active NPI Mental Health Counselor · Ware, MA
NPI 1700530201 · NPPES record last updated Feb 4, 2022
Key facts
- NPI
- 1700530201
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 96 South St
Ware, MA 01082-1616 - Phone
- (413) 262-8935
- NPI assigned
- Feb 4, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
53 Chagnon Rd
Gilbertville, MA 01031-9846
PO Box
Suite 2738
Springfield, MA 01101
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260324000388 | MA | Practitioner - Mental Health Counselor | 0547744054 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
96 South St
Ware, MA 01082-1616
Mailing address
96 South St
Ware, MA 01082-1616
Phone (413) 262-8935
Other providers in Ware, MA
- Ramune Garniene
- Darcy Gauthier
- Richard Gerstein
- Jeremy Giannetti
- Eugene Glabicky
- Natasha Ann Gomez
- Elizabeth Anne Goodale I
- Sarah Gould
- Becca Greene-Van Horn
- George P Grillo
All providers in Ware, MA · Mental Health Counselor in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 4, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.