Provider Demographics
NPI:1003499153
Name:GODLEWSKI, ALISSA MARIE (LCSWA)
Entity Type:Individual
Prefix:
First Name:ALISSA
Middle Name:MARIE
Last Name:GODLEWSKI
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 GOLF COURSE RD APT 1503
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-5253
Mailing Address - Country:US
Mailing Address - Phone:313-728-3122
Mailing Address - Fax:
Practice Address - Street 1:2110 MAIN AVE SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-1405
Practice Address - Country:US
Practice Address - Phone:313-728-3122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0160231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical