MEDICARE: LAJENA GODLEY LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	0124621	NM

General Provider Information

NPI Number	:	1861567240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAJENA GODLEY LMFT

Provider Business Mailing Address
First Line	:	4011 BARBARA LOOP SE STE 205
Second Line	:
City	:	RIO RANCHO
State	:	NM
Zip	:	87124-1041
Country	:	US
Telephone Number	:	505-859-7734
Fax Number	:	505-859-7602

Provider Business Practice Location Address
First Line	:	4011 BARBARA LOOP SE STE 205
Second Line	:
City	:	RIO RANCHO
State	:	NM
Zip	:	87124-1041
Country	:	US
Telephone Number	:	505-342-5493
Fax Number	:	505-342-5450

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	05/06/2025

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