Individual provider Active NPI

Brian Kent Goodwin, LCSW

  • Clinical Social Worker
  • Quincy, IL
National Provider Identifier
1962004176
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149009722 Issued in IL
Practice address
1025 Maine St
Quincy, IL 62301-4096
Phone
(217) 222-6550
Fax
(217) 277-2258
NPI assigned
Nov 12, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149009722 IL Primary

Addresses

Primary practice location

1025 Maine St
Quincy, IL 62301-4096

Mailing address

1300 Spring St
Quincy, IL 62301-2844

Other practice location 1

850 E 2nd St
El Paso, IL 61738-1309
Phone (888) 365-6271

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201125000237 IL Practitioner - Clinical Social Worker 2961813837

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quincy Physicians and Surgeons Clinic, PLLCGroup PAC ID 0749192375, shared by 18 NPIs, 231 clinicians

Practice addresses (Care Compare)

1025 Maine St
Quincy, IL 62301-4038
Phone (217) 222-6550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149009722ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Mar 1, 2021 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC Current Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Mar 1, 2021 Accepting new patients

Locations

1025 Maine St
Quincy, IL 62301
Phone 21722265503163

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1605139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1962004176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 SPRING ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014096",
            "telephone_number": "217-222-6550",
            "fax_number": "217-277-2258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "850 E 2nd St",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "IL",
            "postal_code": "617381309",
            "country_code": "US",
            "telephone_number": "888-365-6271",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "BRIAN",
        "middle_name": "KENT",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-12",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149009722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.