Individual provider Active NPI

Dennis Bond Goodrich

  • Professional Counselor
  • Kalamazoo, MI
National Provider Identifier
1881185148
Registry record updated May 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401015167 Issued in MI
Practice address
1090 N 10TH St Ste 110
Kalamazoo, MI 49009-5733
Phone
(269) 375-4363
NPI assigned
May 22, 2018
Last updated
May 22, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401015167 MI Primary

Addresses

Primary practice location

1090 N 10TH St Ste 110
Kalamazoo, MI 49009-5733

Mailing address

1003 Berkshire Dr
Kalamazoo, MI 49006-6403
Phone (269) 547-9800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240823003133 MI Practitioner - Mental Health Counselor 8224577002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cornerstone Christian Counseling PCGroup PAC ID 1052765674, 9 clinicians

Practice addresses (Care Compare)

1090 N 10TH St
Suite 110
Kalamazoo, MI 49009-5733

2425 S 11TH St
Suite a
Kalamazoo, MI 49009-2113
Phone (269) 375-4363

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401015167MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Christian Counseling PC Professional CurrentSince Jun 16, 2024 Accepting new patients

Locations

1090 N 10th St
Ste 110
Kalamazoo, MI 49009
Phone (269) 375-4363

2425 S 11th St
Ste A
Kalamazoo, MI 49009
Phone (269) 375-4363

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": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1881185148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 BERKSHIRE DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490066403",
            "telephone_number": "269-547-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 N 10TH ST STE 110",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490095733",
            "telephone_number": "269-375-4363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODRICH",
        "first_name": "DENNIS",
        "middle_name": "BOND",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-22",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401015167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.