NPIMap

Organization Active NPI

Goodman'S Behavioral Health Clinic, LLC

  • Community/Behavioral Health Agency
  • Reedsburg, WI
National Provider Identifier
1740458363
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
1798-123 Issued in WI
Legal business name
GOODMAN'S BEHAVIORAL HEALTH CLINIC, LLC
Practice address
2213 E Main St
Reedsburg, WI 53959-9439
Phone
(608) 768-4545
Fax
(608) 768-4646
NPI assigned
Feb 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Barbara Gail Goodman, MSSW, LCSWNPI 1104860998
Title
Owner
Phone
(608) 393-7470

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 1798-123 WI Primary

Addresses

Primary practice location

2213 E Main St
Reedsburg, WI 53959-9439

Mailing address

2213 E Main St
Reedsburg, WI 53959-9439
Phone (608) 768-4545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080502000625 WI Part B Supplier - Clinic/Group Practice 8729167614 Receives reassigned benefits from 5 practitioners
Practice locations: Reedsburg, WI

National Provider Directory

National Provider Directory

Locations

2213 E Main St
Reedsburg, WI 53959
Phone (608) 768-4545

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1203120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1740458363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 E MAIN ST",
            "city": "REEDSBURG",
            "state": "WI",
            "postal_code": "539599439",
            "telephone_number": "608-768-4545",
            "fax_number": "608-768-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 E MAIN ST",
            "city": "REEDSBURG",
            "state": "WI",
            "postal_code": "539599439",
            "telephone_number": "608-768-4545",
            "fax_number": "608-768-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODMAN'S BEHAVIORAL HEALTH CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-16",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "GAIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-393-7470",
        "authorized_official_credential": "MSSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "1798-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reedsburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.