Nancy Goodrich Mitts, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071010734 Issued in IL

Practice address

907 W Marketview Dr Ste 10226
Champaign, IL 61822-1227

Phone

(217) 666-7044

NPI assigned

May 2, 2022

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

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• NGM Counseling, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Champaign, IL
  • NPI 1093427551
  NPD Authorized official

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1720723943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 W MARKETVIEW DR STE 10226",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618221227",
            "telephone_number": "217-666-7044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 W MARKETVIEW DR STE 10226",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618221227",
            "telephone_number": "217-666-7044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODRICH MITTS",
        "first_name": "NANCY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-02",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071010734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danae Gonzalez
• Emily Elizabeth Gonzalez, BA, MHP
• Jeremy Good, PA
• Trudy L. Good, PH.D.
• Lora Linn Goodnight, LCSW
• Elana Esther Gordon, PT
• Jenna Gordon, LCSW
• Matthew Gordon
• Rayal Gorrepati, MD
• Sabrina Gosnell

• Clinical Psychologist in Champaign, IL
• Providers in Champaign, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; 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.