Mandi Carina Goodman, BA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

RC00056762 Issued in WA

Practice address

135 W Main St
Chehalis, WA 98532-4817

Phone

(360) 748-6696

Fax

(360) 748-0627

NPI assigned

Mar 16, 2009

Last updated

Mar 16, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

State licenses

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237161600000",
    "number": "1831330299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 SW THOMSEN AVE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985323750",
            "telephone_number": "360-749-7042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 W MAIN ST",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985324817",
            "telephone_number": "360-748-6696",
            "fax_number": "360-748-0627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "MANDI",
        "middle_name": "CARINA",
        "credential": "BA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-16",
        "last_updated": "2009-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "RC00056762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gold Line Counseling, PLLC
• Amy Gomez Moreno, CNA
• Hailey Gooch, B.S., AAC
• Melissa Good
• Caitlin Alys Goodeill, AAC, SUDPT
• Tracy Lynn Goodrich
• Joshua Peter Gordon, M.D.
• Valinda J Gordon, LMP
• April Grace, CDP
• Michelle Christine Grace, CNA

• Mental Health Counselor in Chehalis, WA
• Providers in Chehalis, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.

Verify at the official NPI Registry.