Active NPI
Mellisa Gooden, M.A.
- Marriage & Family Therapist
- Tampa, FL
National Provider Identifier
1871836155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMT 1787
- Practice address
- 4422 E Columbus Dr
Tampa, FL 33605-3233 - Phone
- (813) 708-8427
- NPI assigned
- Apr 4, 2013
- Last updated
- Apr 4, 2013
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMT 1787 | FL | Primary |
Addresses
Primary practice location
4422 E Columbus Dr
Tampa, FL 33605-3233
Mailing address
7208 Lakes Divide Rd
Apt 8
Temple Terrace, FL 33637-5650
Phone (813) 708-8427
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMT 1787 | FL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365033600000",
"number": "1871836155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7208 LAKES DIVIDE RD",
"address_2": "APT 8",
"city": "TEMPLE TERRACE",
"state": "FL",
"postal_code": "336375650",
"telephone_number": "813-708-8427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4422 E COLUMBUS DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336053233",
"telephone_number": "813-708-8427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODEN",
"first_name": "MELLISA",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-04",
"last_updated": "2013-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "FL",
"license": "IMT 1787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.