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General NPI Number Information
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NPI Number | 1174449631
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Entity Type | Organization
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Legal Business Name | INDY HEALTH PLLC
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Dates
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Enumeration Date | 06/27/2026
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Last Update Date | 06/27/2026
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Provider Practice Location Address
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Address Line | 10240 N 31ST AVE STE 109
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City | PHOENIX
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State | AZ
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Zip | 85051-9564
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Country | US
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Telephone | 480-647-2279
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Fax |
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Provider Business Mailing Address
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Address Line | 10240 N 31ST AVE STE 109
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City | PHOENIX
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State | AZ
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Zip | 85051-9564
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Country | US
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Telephone | 480-647-2279
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER GODLEY
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Credential | PMHNP
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Telephone | 480-647-2279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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