Healthcare Provider Details

I. General information

NPI: 1083527907
Provider Name (Legal Business Name): GODFREY-SMITH COUNSELING DBA GODFREY-SMITH COUNSELING & GENDER CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1255 UNION ST NE FL 7
WASHINGTON DC
20002-7042
US

IV. Provider business mailing address

1255 UNION ST NE
WASHINGTON DC
20002-7042
US

V. Phone/Fax

Practice location:
  • Phone: 903-217-6359
  • Fax:
Mailing address:
  • Phone: 903-217-6359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JESSICA LARISSA GODFREY-SMITH
Title or Position: OWNER
Credential: LPC
Phone: 903-217-6359