Active NPI
Eli Justin Goodman
- Addiction (Substance Use Disorder) Counselor
- Eagan, MN
National Provider Identifier
1922945112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 11305
- Practice address
- 1440 Duckwood Dr Ste 500
Eagan, MN 55122-1399 - Phone
- (612) 440-7250
- NPI assigned
- May 4, 2026
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 11305 | MN | Primary |
Addresses
Primary practice location
1440 Duckwood Dr Ste 500
Eagan, MN 55122-1399
Mailing address
2044 Oakdale Ave Apt 105
West St Paul, MN 55118-4671
Phone (763) 354-9591
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11305 | MN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1777852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777852800000",
"number": "1922945112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2044 OAKDALE AVE APT 105",
"city": "WEST ST PAUL",
"state": "MN",
"postal_code": "551184671",
"telephone_number": "763-354-9591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1440 DUCKWOOD DR STE 500",
"city": "EAGAN",
"state": "MN",
"postal_code": "551221399",
"telephone_number": "612-440-7250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODMAN",
"first_name": "ELI",
"middle_name": "JUSTIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-05-04",
"last_updated": "2026-05-04",
"certification_date": "2026-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "11305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagan, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.