Godfrey, Mary Jane

Godfrey, Mary Jane is an individual health care provider with primary practice located at 2107 Spruce Street , North Collins NY 14111. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Godfrey, Mary Jane can be contacted via phone (716) 842-0440.

Contact Information

Primary practice address
2107 Spruce Street North Collins NY 14111
Phone: (716) 842-0440
Fax: (716) 842-4069
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 085183 New York
Behavioral Health & Social Service Providers / Clinical 1041C0700X 084119 New York

Profile Details

NPI number 1760769384
LBN Legal business name Godfrey, Mary Jane
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 10th, 2011
Last updated Nov 22nd, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760769384 NPPES
New York MEDICAID 1760769384

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