Healthcare Provider Details

I. General information

NPI: 1972450674
Provider Name (Legal Business Name): KATERIN GODOY
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2026
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 SPRING ST STE 101
SILVER SPRING MD
20910-2756
US

IV. Provider business mailing address

11510 LAURELWALK DR
LAUREL MD
20708-3002
US

V. Phone/Fax

Practice location:
  • Phone: 240-398-3514
  • Fax:
Mailing address:
  • Phone: 240-559-6456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: