Active NPI
Amy Goles, M.A., LCPC
- Mental Health Counselor
- Batavia, IL
National Provider Identifier
1871862110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 180008067
- Practice address
- 12 W Wilson St
Suite a
Batavia, IL 60510-2891 - Phone
- (630) 715-5740
- NPI assigned
- Dec 15, 2011
- Last updated
- Nov 5, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | 180008067 | IL | Primary |
Addresses
Primary practice location
12 W Wilson St
Suite a
Batavia, IL 60510-2891
Mailing address
12 W Wilson St
Suite a
Batavia, IL 60510-2891
Phone (630) 715-5740
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 |
|---|---|---|---|
| 180008067 | IL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prairie Wellness Counseling Center, P.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446681600000",
"number": "1871862110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 W WILSON ST",
"address_2": "SUITE A",
"city": "BATAVIA",
"state": "IL",
"postal_code": "605102891",
"telephone_number": "630-715-5740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 W WILSON ST",
"address_2": "SUITE A",
"city": "BATAVIA",
"state": "IL",
"postal_code": "605102891",
"telephone_number": "630-715-5740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLES",
"first_name": "AMY",
"name_prefix": "Mrs.",
"credential": "M.A., LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-15",
"last_updated": "2015-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "180008067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Batavia, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.