Individual provider Active NPI

Matthew Gooder

  • Clinical Social Worker
  • Plymouth, MI
National Provider Identifier
1790434751
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
9409 N Haggerty Rd
Plymouth, MI 48170-4696
Phone
(734) 559-3540
NPI assigned
Mar 18, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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 Primary

Addresses

Primary practice location

9409 N Haggerty Rd
Plymouth, MI 48170-4696

Mailing address

4120 Sara St
Hudsonville, MI 49426-9398

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20250514002407 MI Practitioner - Clinical Social Worker 7911425889 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Transformational Services LLCGroup PAC ID 8820219322, 34 clinicians

Practice addresses (Care Compare)

9409 N Haggerty Rd
Plymouth, MI 48170-4696
Phone (734) 559-3540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Transformational Services LLC Clinical CurrentSince Mar 1, 2025 Accepting new patients
Michigan Safe Space LLC Clinical CurrentSince Mar 1, 2025 Accepting new patients

Locations

9401 N Haggerty Rd
Plymouth, MI 48170
Phone (734) 301-7668

9409 N Haggerty Rd
Plymouth, MI 48170
Phone (734) 231-3933

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1790434751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 SARA ST",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494269398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9409 N HAGGERTY RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704696",
            "telephone_number": "734-559-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODER",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-18",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

Verify at the official NPI Registry.