Wendy Anne Goetz, LLP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6361006934 Issued in MI

Practice address

42669 Garfield Rd
Clinton Township, MI 48038-1653

Phone

(586) 412-5321

NPI assigned

Aug 14, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Wendy Anne Hayek Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Lakeside Professional Counseling, P.C.

  • Mental Health Counselor
  • Shelby Township, MI
  • NPI 1073084083
  NPD (past)

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588550400000",
    "number": "1750394235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6549 TOWN CENTER DR STE A",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464824",
            "telephone_number": "248-620-6400",
            "fax_number": "248-620-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42669 GARFIELD RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381653",
            "telephone_number": "586-412-5321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12850 Fountain Sq",
            "address_2": "Ste. 106",
            "address_purpose": "LOCATION",
            "city": "Davisburg",
            "state": "MI",
            "postal_code": "483502552",
            "country_code": "US",
            "telephone_number": "248-634-6303",
            "fax_number": "248-634-1746",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOETZ",
        "first_name": "WENDY",
        "middle_name": "ANNE",
        "credential": "LLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301011648",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6361006934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WENDY",
            "last_name": "HAYEK",
            "middle_name": "ANNE",
            "credential": "LLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• GMC Pharmacy LLC
• GMP Network
• Christine Chan-How Go, PA-C
• Latfiah Gobah, LMSW
• Shane Daryl Gober, D.O.
• Mary-Kate Goff, LLPC
• Golden Family Practice PLLC
• Golden Years in Home Care LLC
• Amanda Renee Golder, LLBSW
• Grecia I Gomez

• Clinical Psychologist in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2020; 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.