Provider Demographics
NPI:1033598396
Name:GODEL, KARISSA JOY (MS, LPCC, LADC)
Entity Type:Individual
Prefix:
First Name:KARISSA
Middle Name:JOY
Last Name:GODEL
Suffix:
Gender:F
Credentials:MS, LPCC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7945 STONE CREEK DR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:CHANHASSEN
Mailing Address - State:MN
Mailing Address - Zip Code:55317-4605
Mailing Address - Country:US
Mailing Address - Phone:952-974-3999
Mailing Address - Fax:952-974-3780
Practice Address - Street 1:7945 STONE CREEK DR
Practice Address - Street 2:SUITE 140
Practice Address - City:CHANHASSEN
Practice Address - State:MN
Practice Address - Zip Code:55317-4605
Practice Address - Country:US
Practice Address - Phone:952-974-3999
Practice Address - Fax:952-974-3780
Is Sole Proprietor?:No
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN304064101YA0400X
MN951101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)