Matthew Gerald Goodman

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

178.008168 Issued in IL

Practice address

6651 Chippewa St Ste 224
Saint Louis, MO 63109-2531

Phone

(314) 645-6840

NPI assigned

Sep 17, 2012

Last updated

Sep 17, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347840000000",
    "number": "1841540994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ANNA ST LOT 31",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622263902",
            "telephone_number": "618-550-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6651 CHIPPEWA ST STE 224",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631092531",
            "telephone_number": "314-645-6840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "MATTHEW",
        "middle_name": "GERALD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-17",
        "last_updated": "2012-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.008168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Earl Goodman, DDS
• Gary M Goodman, MD
• Jared Vega Goodman, MD
• Joseph Goodman, RN
• Kyle Nicholas Goodman, MD, PHD
• Meaghan Cathleen Goodman, M.A., CCC-SLP
• Michael Ray Goodman, LPC
• Zachary Avital Goodman, M.D.
• Matthew Michael Goodmanson, M.D.
• Asha Lyn Goodner, FNP

• Mental Health Counselor in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Mental Health Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; 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.