Individual provider Active NPI

Janice Mary Goodison, LCSW

  • Social Worker
  • Tooele, UT
National Provider Identifier
1871552992
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
5171789-3502 Issued in UT
Practice address
6563 Sky Heights Dr
Tooele, UT 84074-3097
Phone
(406) 499-2709
NPI assigned
Mar 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 5171789-3502 UT Primary

Addresses

Primary practice location

6563 Sky Heights Dr
Tooele, UT 84074-3097

Mailing address

6563 Sky Heights Dr
Tooele, UT 84074-3097
Phone (406) 499-2709

Other names 1

  • Janice McCaffrey Former name

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

LicenseStateTypeSpecialty
5171789-3502UTMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Support Center Past Accepting new patients
Family Support Center Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1871552992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6563 SKY HEIGHTS DR",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840743097",
            "telephone_number": "406-499-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6563 SKY HEIGHTS DR",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840743097",
            "telephone_number": "406-499-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODISON",
        "first_name": "JANICE",
        "middle_name": "MARY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-18",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": "5171789-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANICE",
            "last_name": "MCCAFFREY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tooele, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; 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.