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

Ryan Goman, LICSW

Individual provider Clinical Social Worker · NPI 1639606502

Ryan Goman, LICSW is a Clinical Social Worker in New Hope, Minnesota. Qualified in 2018, 8 years ago. Practices with Fairview Express Care, a 1,964-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
8
Licensed in
MN
In the registry since
2017
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

5555 Boone Ave N
New Hope, MN 55428-3636
Phone: (651) 774-0011
Fax: (651) 774-0606
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 12149 Tulip St Nw, Coon Rapids, MN 55433-6767 — (612) 834-4703

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 20723 (MN)

Record details

NPI number1639606502
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorYes
NPI enumeratedMay 22, 2017
Last updated in NPPESAugust 24, 2023
Certification dateAugust 24, 2023
Mailing address12149 Tulip St Nw, Coon Rapids, MN 55433-6767

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Fairview Express Care — 1964 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in New Hope