CHARLENE LABOTTE GOODE — NPI 1154571040 (Licensed & Credentialed Developmental Therapist in GALENA, IL)

CMS-1500 Box 24J / 33a • NPI

1154571040

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

222Q00000X

Licensed & Credentialed Developmental Therapist

Box 32 Service Location & ZIP+4

9056 COTTONWOOD DR, GALENA, IL, 61036-9401

✓ 9-Digit EDI 837 ZIP+4 (61036-9401)

Practice Phone & Referral Fax

(815) 777-6544

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1154571040 (CHARLENE LABOTTE GOODE) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1154571040` (NPI-1 Individual Practitioner)
Provider / Legal Name	CHARLENE LABOTTE GOODE
Plain-English Specialty	Licensed & Credentialed Developmental Therapist NUCC Code: `222Q00000X` (Developmental Therapist)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	9056 COTTONWOOD DR, GALENA, IL, 61036-9401
Practice Telephone / Fax	Tel: (815) 777-6544
Administrative Mailing Address	245 W EXCHANGE ST, SYCAMORE, IL, 60178-1495
Enumeration & Last Sync	Enumerated: 2008-09-26 \| CMS Record Updated: 2013-03-22

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

9056 COTTONWOOD DR, GALENA, IL, 61036-9401

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Plain-English Taxonomy & CMS Crosswalk (222Q00000X)

What Does Taxonomy Code 222Q00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 222Q00000X translates to:
"Licensed & Credentialed Developmental Therapist"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Developmental Therapist for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (CHARLENE LABOTTE GOODE)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`222Q00000X` — Developmental Therapist Plain English: Licensed & Credentialed Developmental Therapist	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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CHARLENE LABOTTE GOODE (NPI #1154571040)