Provider Demographics
NPI:1003340530
Name:GODETTE, KARAN (MED, MA, LPC)
Entity Type:Individual
Prefix:
First Name:KARAN
Middle Name:
Last Name:GODETTE
Suffix:
Gender:F
Credentials:MED, MA, LPC
Other - Prefix:
Other - First Name:KARAN
Other - Middle Name:
Other - Last Name:FLEMING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:441 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-4232
Mailing Address - Country:US
Mailing Address - Phone:803-775-5080
Mailing Address - Fax:
Practice Address - Street 1:441 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4232
Practice Address - Country:US
Practice Address - Phone:803-775-5080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-16486101YP2500X
SC7029101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional