MEDICARE: GOSHORN PSYCH-SERVICES PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	G-096742	IA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01035746	OTHER	IA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1255365631	OTHER	IA	WELLMARK BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477857704
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOSHORN PSYCH-SERVICES PLLC

Provider Business Mailing Address
First Line	:	935 W 18TH ST S
Second Line	:
City	:	NEWTON
State	:	IA
Zip	:	50208-3500
Country	:	US
Telephone Number	:	515-255-7414
Fax Number	:	515-274-6913

Provider Business Practice Location Address
First Line	:	935 W 18TH ST S
Second Line	:
City	:	NEWTON
State	:	IA
Zip	:	50208-3500
Country	:	US
Telephone Number	:	641-871-0764
Fax Number	:	641-792-2745

Authorized Official
Title or Position	:	OWNER
Name	:	CINDY RENEE GOSHORN
Credential	:	DNP, ARNP
Telephone Number	:	641-205-3100

Provider Enumeration Date	:	12/30/2010
Last Update Date	:	05/14/2026

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Directions to “GOSHORN PSYCH-SERVICES PLLC ” Practice Location

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