CMS-1500 Box 24J / 33a • NPI
1417680125
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
103T00000X (CMS 62)
Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist
Box 32 Service Location & ZIP+4
910 CATHY DR, TEA, SD, 57064-2199
✓ 9-Digit EDI 837 ZIP+4 (57064-2199)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1417680125 (GOOD KARMA WELLNESS, LLC) 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
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1417680125 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | GOOD KARMA WELLNESS, LLC |
| Plain-English Specialty | Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist NUCC Code: 103T00000X (Psychologist) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 910 CATHY DR, TEA, SD, 57064-2199 |
| Practice Telephone / Fax | Tel: (507) 213-6171 |
| Administrative Mailing Address | 4800 S LOUISE AVE, SIOUX FALLS, SD, 57106-2217 |
| Enumeration & Last Sync | Enumerated: 2022-07-08 | CMS Record Updated: 2023-12-25 |
| Authorized Official | TRISHA GAUDIG (Psychologist) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (103T00000X)
What Does Taxonomy Code 103T00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103T00000X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (GOOD KARMA WELLNESS, LLC)
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
- 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 |
|---|---|
261QM0850X — Clinic/Center, Adult Mental HealthPlain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center | State: N/A | License: Verified | Primary: Secondary |
261QM0855X — Clinic/Center, Adolescent and Children Mental HealthPlain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center | State: N/A | License: Verified | Primary: Secondary |
103TC0700X — Psychologist, ClinicalPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Clinical | State: N/A | License: Verified | Primary: Secondary |
103TC1900X — Psychologist, CounselingPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Counseling | State: N/A | License: Verified | Primary: Secondary |
251S00000X — Community/Behavioral HealthPlain English: Licensed & Credentialed Community/Behavioral Health | State: N/A | License: Verified | Primary: Secondary |
103T00000X — PsychologistPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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