Brittannie Drake Goodman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C11415 Issued in MS

Practice address

192 Harvey Xing
Canton, MS 39046-4523

Phone

(662) 436-7067

NPI assigned

Jan 15, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1736899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1831900133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 HARVEY XING",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390464523",
            "telephone_number": "662-436-7067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 HARVEY XING",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390464523",
            "telephone_number": "662-436-7067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "BRITTANNIE",
        "middle_name": "DRAKE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-15",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MS",
            "license": "C11415",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C11415",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MS",
            "license": "C11415",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anita Lasheryl Gibson
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• Parvesh K Goel, M.D.
• Goodloe Dental, P.a.
• Austin Taylor Goodman, PT
• Grace Counseling PLLC
• Graceful Journeys LLC
• Katina Grant, FNP-C
• Green Acre LLC
• Allison Groves, SLP

• Clinical Social Worker in Canton, MS
• Providers in Canton, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.