Individual provider Active NPI

Sonya Carol Goodrich, LCSW

  • Clinical Social Worker
  • Medina, TN
National Provider Identifier
1770181661
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7414 Issued in TN
Practice address
320 Spring Creek Hwy
Medina, TN 38355-9779
Phone
(731) 487-3179
NPI assigned
Oct 13, 2020
Last updated
Oct 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7414 TN Primary

Addresses

Primary practice location

320 Spring Creek Hwy
Medina, TN 38355-9779

Mailing address

320 Spring Creek Hwy
Medina, TN 38355-9779
Phone (731) 487-3179

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201229001437 TN Practitioner - Clinical Social Worker 7416360086 Reassigns benefits to 1 organization
Practice locations: Medina, TN

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7414TNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Jan 13, 2024 Accepting new patients

Locations

40 Burton Hills Blvd
Ste 200
Nashville, TN 37215
Phone (615) 257-8410

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1770181661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 SPRING CREEK HWY",
            "city": "MEDINA",
            "state": "TN",
            "postal_code": "383559779",
            "telephone_number": "731-487-3179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 SPRING CREEK HWY",
            "city": "MEDINA",
            "state": "TN",
            "postal_code": "383559779",
            "telephone_number": "731-487-3179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODRICH",
        "first_name": "SONYA",
        "middle_name": "CAROL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "7414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, TN

Sources for this page

Verify at the official NPI Registry.