Kelsey Marie Goodwin, MSW/ASW

Individual provider Active NPI Mental Health Counselor · Joshua Tree, CA

NPI 1710530985 · NPPES record last updated Sep 23, 2019

Key facts

NPI
1710530985
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
91223 (CA)
Practice address
60805 29 Palms Hwy
Joshua Tree, CA 92252-5901
Phone
(760) 974-5990
NPI assigned
Jul 17, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
91223CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Star Behavioral Health, Inc. Past
since Jul 25, 2019
Accepting new patients
Valley Star Behavioral Health, Inc. Past
since Jul 25, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 91223 CA Yes

Addresses

Primary practice location

60805 29 Palms Hwy
Joshua Tree, CA 92252-5901

Mailing address

35294 Adams LN Apt F
Yucaipa, CA 92399-3857

Other providers in Joshua Tree, CA

All providers in Joshua Tree, CA · Mental Health Counselor in California

Sources for this page

Verify at the official NPI Registry.