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General NPI Number Information
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NPI Number | 1407313976
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Entity Type | Individual
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Provider Name | KATHARINE GODFREY LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/20/2019
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 4833 CAROLINA BEACH RD STE 106
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City | WILMINGTON
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State | NC
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Zip | 28412-2370
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Country | US
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Telephone | 910-603-8981
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Fax |
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Provider Business Mailing Address
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Address Line | 2051 TWILIGHT DR NE
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City | WINNABOW
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State | NC
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Zip | 28479-5054
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Country | US
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Telephone | 910-603-8981
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | P013057
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License Number State | NC
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