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General NPI Number Information
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NPI Number | 1700172624
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Entity Type | Individual
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Provider Name | THOMAS GODFREY MSW, LCSW
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Gender | Male
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Dates
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Enumeration Date | 06/20/2011
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Last Update Date | 06/20/2024
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Provider Practice Location Address
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Address Line | 3930 W CHESTER PIKE
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City | NEWTOWN SQUARE
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State | PA
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Zip | 19073-3209
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Country | US
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Telephone | 401-208-6011
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Fax | 267-350-4887
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Provider Business Mailing Address
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Address Line | 3930 W CHESTER PIKE
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City | NEWTOWN SQUARE
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State | PA
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Zip | 19073-3209
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Country | US
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Telephone | 401-208-6011
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Fax | 267-350-4887
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 32959
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 11724123
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW016586
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License Number State | PA
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