Active NPI
Roberta R Goodman, LPAT
- Mental Health Counselor
- Tesuque, NM
National Provider Identifier
1831269448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0438
- Practice address
- 187 Tesuque Village Rd
Tesuque, NM 87506 - Phone
- (505) 988-3686
- Fax
- (505) 310-1576
- NPI assigned
- Nov 9, 2006
- Last updated
- May 21, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0438 | NM | Primary |
Addresses
Primary practice location
187 Tesuque Village Rd
Tesuque, NM 87506
Mailing address
PO Box 1111
Santa Fe, NM 87504-1111
Phone (505) 988-3686
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0438 | NM | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242864000000",
"number": "1831269448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1111",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875041111",
"telephone_number": "505-988-3686",
"fax_number": "505-310-1576"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "187 TESUQUE VILLAGE RD",
"city": "TESUQUE",
"state": "NM",
"postal_code": "87506",
"telephone_number": "505-988-3686",
"fax_number": "505-310-1576"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODMAN",
"first_name": "ROBERTA",
"middle_name": "R",
"name_prefix": "Ms.",
"credential": "LPAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-09",
"last_updated": "2009-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "0438",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tesuque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.