Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Carl Robert Goodholm Jr., LCSW

Individual provider Clinical Social Worker · NPI 1609411024

Mr. Carl Robert Goodholm Jr., LCSW is a Clinical Social Worker in Jacksonville, Florida. Qualified in 2002, 24 years ago. Practices with Mayo Clinic Jacksonville, a 1,581-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
24
Licensed in
FL
In the registry since
2019
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone: (904) 953-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence SW9760 (FL)

Record details

NPI number1609411024
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedNovember 8, 2019
Last updated in NPPESOctober 12, 2020
Certification dateOctober 12, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Mayo Clinic Jacksonville — 1581 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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