Provider Demographics
NPI:1205394632
Name:GODNYUK, VICTORIA (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:
Last Name:GODNYUK
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 458
Mailing Address - Street 2:
Mailing Address - City:HOWARD LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55349-0458
Mailing Address - Country:US
Mailing Address - Phone:320-543-6847
Mailing Address - Fax:
Practice Address - Street 1:606 8TH AVE
Practice Address - Street 2:
Practice Address - City:HOWARD LAKE
Practice Address - State:MN
Practice Address - Zip Code:55349
Practice Address - Country:US
Practice Address - Phone:763-732-2482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-05
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2057101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional