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NICOLE LYNN GOOLSBY LMFT
NPI 1124350475
Marriage & Family Therapist in Claremont, CA

Active since February 10, 2010Opted out of Medicare · through Jan 12, 2028
219 N INDIAN HILL BLVD STE 102, CLAREMONT, CA 91711(909) 206-4453 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, May 21, 2020, Mar 15, 2019 and 2 more (5 updates tracked since 2017).

About Nicole Lynn Goolsby Lmft NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE LYNN GOOLSBY LMFT (NPI 1124350475) is an individual marriage & family therapist in Claremont, California, licensed in California (98829) and active in the NPI registry since February 2010. She has opted out of Medicare through January 12, 2028 and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1124350475
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameNICOLE LYNN GOOLSBYCredential: LMFT
Location Address219 N INDIAN HILL BLVD STE 102Claremont, CA 91711-4644
Mailing AddressPo Box 9266Rancho Cucamonga, CA 91701-8266 · (909) 206-4453
Phone(909) 206-4453
Sole ProprietorNo
Enumeration DateFebruary 10, 2010
Last NPPES UpdateJuly 21, 20225 updates tracked since enumeration
NPPES CertifiedMay 21, 2020
✔ NPI 1124350475 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in CA · 98829
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
219 N INDIAN HILL BLVD STE 102, Claremont, CA 91711
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Secondary Practice Locations 2

Location 1790 E Bonita AvePomona, CA 91767-1906 · Phone (909) 935-5228
Location 210601 Civic Center Dr Ste 120BRancho Cucamonga, CA 91730-3878 · Phone (909) 206-4453

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Nicole Lynn Goolsby Lmft has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 12, 2024 through January 12, 2028.

Opt-Out Effective DateJanuary 12, 2024
Opt-Out In Effect ThroughJanuary 12, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALYSSA DAVIS RD
Dietitian, Registered
219 N INDIAN HILL BLVD STE 102
CLAREMONT, CA 91711
Los Angeles County (909) 578-0719
SHELLY NICOLE HOLYBEE M.A. LMFT
Marriage & Family Therapist
219 N INDIAN HILL BLVD STE 102
CLAREMONT, CA 91711
Los Angeles County (909) 529-0849
JANET CARRASCO LCSW
Social Worker
219 N INDIAN HILL BLVD STE 102
CLAREMONT, CA 91711
Los Angeles County (562) 472-8501
NICOLE GOOLSBY, LICENSED MARRIAGE AND FAMILY THERAPIST, INC.
Clinic/Center (Mental Health (Including Community Mental Health Center))
219 N INDIAN HILL BLVD STE 102
CLAREMONT, CA 91711
Los Angeles County (909) 206-4453
BRITTANY LACE CANADY RDN, CEDRD
Dietitian, Registered
219 N INDIAN HILL BLVD STE 102
CLAREMONT, CA 91711
Los Angeles County (323) 457-3606
ANNE RICKETTS LMFT
Marriage & Family Therapist
219 N INDIAN HILL BLVD STE 102
CLAREMONT, CA 91711
Los Angeles County (310) 892-6383

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Goolsby's NPI number?

The NPI number for Nicole Goolsby is 1124350475. It was assigned to this individual provider in the NPPES registry on February 10, 2010.

Where is Nicole Goolsby located?

Nicole Goolsby practices at 219 N Indian Hill Blvd Ste 102, Claremont, CA 91711. The listed phone number is (909) 206-4453.

What is Nicole Goolsby's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Nicole Goolsby enrolled in Medicare?

No. Nicole Goolsby has opted out of Medicare through January 12, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Nicole Goolsby was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.