Lisa M Goodson

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178.012011 Issued in IL

Practice address

175 E Hawthorn Pkwy
Vernon Hills, IL 60061-1463

Phone

(847) 868-3435

NPI assigned

Sep 5, 2012

Last updated

Feb 8, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lifestancehealth.lisagoodson@146897.advancedmd-direct.com

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

• Edgewood Clinical Services, P.C.

  dba LifeStance

  • Psychologist
  • Naperville, IL
  • NPI 1295914646
  NPD (past)

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1871842054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 VISTA CT APT 201",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601935172",
            "telephone_number": "708-374-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E HAWTHORN PKWY",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611463",
            "telephone_number": "847-868-3435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODSON",
        "first_name": "LISA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-05",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.012011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Goduco Family Dentistry, LTD.
• Philip Villejo Goduco, DDS
• Leslie Ann Golde, LCSW
• Michelle Lynn Goldstein
• Vianka Gonzalez
• Sharon Ann Goodzey, DMD
• Tamara Gopal, LSW
• Abigail Gordon
• Graber Orthodontics
• Lee Graber, D.D.S.

• Professional Counselor in Vernon Hills, IL
• Providers in Vernon Hills, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; 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.