Healthcare Provider Details

I. General information

NPI: 1104410737
Provider Name (Legal Business Name): RHEA LAUREN GODSEY LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2021
Last Update Date: 02/24/2021
Certification Date: 02/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 1ST ST NE FL 9
WASHINGTON DC
20002-7953
US

IV. Provider business mailing address

9801 APOLLO DR UNIT 7261
LARGO MD
20792-5555
US

V. Phone/Fax

Practice location:
  • Phone: 202-442-7111
  • Fax:
Mailing address:
  • Phone: 301-821-3861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17929
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC50082269
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: