DESTINY NICOLE GOLDNER (MS, LMHC-A) – Mental Health Counselor, NPI 1619665767

DESTINY NICOLE GOLDNER (MS, LMHC-A) is a healthcare provider. based in Sullivan, Indiana. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MS, LMHC-A. They hold a License No. 39005657A (IN). The NPI Number for DESTINY NICOLE GOLDNER (MS, LMHC-A) is 1619665767

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
DESTINY NICOLE GOLDNER (MS, LMHC-A)
NPI
1619665767
Phone
(812) 268-2562
Address
2232 N Hospital Blvd Ste 2
Enumeration Date
26 April 2023
Last Update Date
18 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8122684311
Graduation Year
2022 (4 years ago)
PAC ID
1153788666
Group Practice PAC ID
2466497482
Professional Enrollment ID
I20250925002911
Address ID
IN478827523SU2200XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness85
Years active:3State licenses:1Digital endpointsOther names

893 MENTAL HEALTH COUNSELOR in IN

Provider Addresses for DESTINY NICOLE GOLDNER (MS, LMHC-A)

  • 2232 N Hospital Blvd Ste 2

    Sullivan, IN 478827674

    Phone: (812) 268-2562

    Type: Location

  • PO BOX 10

    SULLIVAN, IN 478820010

    Phone: (812) 268-4311

    Type: Mailing

  • 2200 N SECTION ST

    SULLIVAN, IN 478827523

    Phone: (812) 268-4311

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-09-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250925002911IMental Health CounselorINTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 47882)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2466497482View full group profile
NameSpecialtyState
Nurse PractitionerIN
Nurse PractitionerIN
Mental Health CounselorIN
Family PracticeIN
Nurse PractitionerIN
Nurse PractitionerIN
Nurse PractitionerIN
Psychiatry, Internal Medicine, NeuropsychiatryGA
Family PracticeND
Pain ManagementOH

Reviews

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Frequently asked questions

What identifier follows DESTINY NICOLE GOLDNER (MS, LMHC-A) across health systems?
The NPI 1619665767 uniquely identifies DESTINY NICOLE GOLDNER (MS, LMHC-A) in U.S. healthcare data.
Quick check: is DESTINY NICOLE GOLDNER (MS, LMHC-A) active?
Public NPPES data shows DESTINY NICOLE GOLDNER (MS, LMHC-A) with an active NPI status right now.
What type of care does DESTINY NICOLE GOLDNER (MS, LMHC-A) provide?
DESTINY NICOLE GOLDNER (MS, LMHC-A)'s profile centers on Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What geographic area is tied to DESTINY NICOLE GOLDNER (MS, LMHC-A)?
DESTINY NICOLE GOLDNER (MS, LMHC-A) is associated with Sullivan, Indiana in the same public data insurers reference.
Who maintains DESTINY NICOLE GOLDNER (MS, LMHC-A)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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