Active NPI
Hailey Goodwin, LCMHCA
- Mental Health Counselor
- Charlotte, NC
National Provider Identifier
1851024624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- A17790
- Practice address
- 5970 Fairview Rd Ste 575
Charlotte, NC 28210-3167 - Phone
- (704) 332-5123
- NPI assigned
- Jul 7, 2022
- 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 | A17790 | NC | Primary |
Addresses
Primary practice location
5970 Fairview Rd Ste 575
Charlotte, NC 28210-3167
Mailing address
141 Remount Rd Apt 10301
Charlotte, NC 28203-6491
Phone (704) 960-0801
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 |
|---|---|---|---|
| A17790 | NC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674000000000",
"number": "1851024624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 REMOUNT RD APT 10301",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282036491",
"telephone_number": "704-960-0801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5970 FAIRVIEW RD STE 575",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282103167",
"telephone_number": "704-332-5123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODWIN",
"first_name": "HAILEY",
"credential": "LCMHCA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-07",
"last_updated": "2023-01-18",
"certification_date": "2023-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "A17790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.