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General NPI Number Information
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NPI Number | 1801391982
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Entity Type | Organization
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Legal Business Name | GODAELLI HEALTHCARE SERVICES
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Dates
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Enumeration Date | 03/29/2018
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 1455 OLD BRIDGE RD STE 204
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City | WOODBRIDGE
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State | VA
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Zip | 22192-2727
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Country | US
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Telephone | 703-870-0738
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Fax |
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Provider Business Mailing Address
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Address Line | 170 WOODSTREAM BLVD
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City | STAFFORD
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State | VA
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Zip | 22556-4629
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Country | US
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Telephone | 240-320-4996
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ELIZABETH ONYEJEKWE
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Credential | PMHNP
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Telephone | 240-320-4996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | HCO-1814
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License Number State | VA
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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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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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