Kenneth Kriss Goodrow II, MS, LPCC, NCC, CCMHC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

0078151 Issued in NM

Practice address

3949 Corrales Rd Ste 105
Corrales, NM 87048-9347

Phone

(505) 239-7459

Fax

(505) 899-4060

NPI assigned

Sep 26, 2006

Last updated

Nov 14, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

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

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Goodrow Family & Youth Institute

  • Community/Behavioral Health Agency
  • Albuquerque, NM
  • NPI 1669736856
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1932200417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 CORRALES RD UNIT 520",
            "city": "CORRALES",
            "state": "NM",
            "postal_code": "870484020",
            "telephone_number": "505-239-7459",
            "fax_number": "505-899-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3949 CORRALES RD STE 105",
            "city": "CORRALES",
            "state": "NM",
            "postal_code": "870489347",
            "telephone_number": "505-239-7459",
            "fax_number": "505-899-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODROW",
        "first_name": "KENNETH",
        "middle_name": "KRISS",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "MS, LPCC, NCC, CCMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NM",
            "license": "0078151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09881522",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Garcia
• Teresa Arlene Gigante, MA, LPCC
• Erik Jackson Gimler
• Marie Ginga, LPCC
• Golden Heart New Mexico LLC (Golden Heart Hospice)
• Kylee J Gordley-Shurter, LPCC
• Jerome Eldon Goss, MD
• Gail J Grambling Harrison, LPCC
• Grambling Therapy Inc
• Gray Wolf Counseling, Inc.

• Community/Behavioral Health Agency in Corrales, NM
• Providers in Corrales, NM by specialty
• Community/Behavioral Health Agency in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.