Connie Jo Goldsmith, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.002482 Issued in IL

Practice address

1520 S 4TH St
Greenville, IL 62246-2618

Phone

(618) 664-1455

Fax

(618) 664-1374

NPI assigned

Nov 10, 2008

Last updated

Nov 9, 2009By 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 1

Addresses

Other names 1

• Connie Jo Austin Former name

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Mental Health Counselor

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bond County TreasurerGroup PAC ID 0446355820, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bond County Treasurer

  • Community/Behavioral Health Agency
  • Greenville, IL
  • NPI 1437238177
  Medicare reassignment Care Compare group NPD
• Bond County Treasurer

  dba Bond County Health Department

  • Public Health or Welfare Agency
  • Greenville, IL
  • NPI 1598869182
  NPD

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

{
    "created_epoch": "1226275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257724800000",
    "number": "1922252584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 S 4TH ST",
            "city": "GREENVILLE",
            "state": "IL",
            "postal_code": "622462618",
            "telephone_number": "618-664-1455",
            "fax_number": "618-664-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 S 4TH ST",
            "city": "GREENVILLE",
            "state": "IL",
            "postal_code": "622462618",
            "telephone_number": "618-664-1455",
            "fax_number": "618-664-1374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSMITH",
        "first_name": "CONNIE",
        "middle_name": "JO",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-10",
        "last_updated": "2009-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.002482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNIE",
            "last_name": "AUSTIN",
            "middle_name": "JO",
            "credential": "LCPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Greenville, IL
• Providers in Greenville, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.