Active NPI
Ena Simone Goods, MS
- Counselor
- Jackson, MS
National Provider Identifier
1982766804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 860 E River PL
Jackson, MS 39202-3442 - Phone
- (601) 642-8845
- NPI assigned
- Dec 15, 2006
- Last updated
- Jan 6, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
860 E River PL
Jackson, MS 39202-3442
Mailing address
9 Roux 61 Dr Ste C
Natchez, MS 39120-2176
Other practice location 1
4012 Carter St
Vidalia, LA 71373-3013
Phone (318) 336-8383
Other practice location 2
1701 White St
McComb, MS 39648
Phone (601) 684-2173
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
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SW Ms Mental Health Mental Retardation Commission | Current | Accepting new patients | |
| Southwest Mississippi Mental Health Mental Retardation Commission | Past | Accepting new patients |
Locations
1701 White St
McComb, MS 39648
Phone (601) 249-4217
Organizations & group practices 2
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- McComb, MS
- NPI 1184662694
-
dba SW Ms Mental Health Region XI
- Social Worker
- McComb, MS
- NPI 1366694820
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609891200000",
"number": "1982766804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 ROUX 61 DR STE C",
"city": "NATCHEZ",
"state": "MS",
"postal_code": "391202176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "860 E RIVER PL",
"city": "JACKSON",
"state": "MS",
"postal_code": "392023442",
"telephone_number": "601-642-8845"
}
],
"practiceLocations": [
{
"address_1": "4012 Carter St",
"address_purpose": "LOCATION",
"city": "Vidalia",
"state": "LA",
"postal_code": "713733013",
"country_code": "US",
"telephone_number": "318-336-8383",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1701 White St",
"address_purpose": "LOCATION",
"city": "McComb",
"state": "MS",
"postal_code": "39648",
"country_code": "US",
"telephone_number": "601-684-2173",
"fax_number": "601-249-4234",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOODS",
"first_name": "ENA",
"middle_name": "SIMONE",
"name_prefix": "Ms.",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-15",
"last_updated": "2021-01-06",
"certification_date": "2021-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.