Nicole Goolsby, Licensed Marriage and Family Therapist, Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

NICOLE GOOLSBY, LICENSED MARRIAGE AND FAMILY THERAPIST, INC.

Practice address

219 N Indian Hill Blvd Ste 102
Claremont, CA 91711-4644

Phone

(909) 206-4453

NPI assigned

Mar 15, 2019

Organization subpart

No

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

Authorized official

Name

Nicole GoolsbyNPI 1124350475

Title

LMFT/Owner

Phone

(909) 206-4453

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Nicole Lynn Goolsby, LMFT

  • Marriage & Family Therapist
  • Claremont, CA
  • NPI 1124350475
  NPD Authorized official

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

{
    "created_epoch": "1552608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590019200000",
    "number": "1760941199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9266",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917018266",
            "telephone_number": "909-206-4453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 N INDIAN HILL BLVD STE 102",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917114644",
            "telephone_number": "909-206-4453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLE GOOLSBY, LICENSED MARRIAGE AND FAMILY THERAPIST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-15",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A",
        "authorized_official_last_name": "GOOLSBY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "LMFT/OWNER",
        "authorized_official_telephone_number": "909-206-4453"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Claremont, CA
• Providers in Claremont, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.