Provider Demographics
NPI:1316837917
Name:GODUTI, HEATHER E (LMSW)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:E
Last Name:GODUTI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 ALBANY TPKE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:CT
Mailing Address - Zip Code:06019-2546
Mailing Address - Country:US
Mailing Address - Phone:475-265-0696
Mailing Address - Fax:
Practice Address - Street 1:166 ALBANY TPKE STE 4B
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:CT
Practice Address - Zip Code:06019-2546
Practice Address - Country:US
Practice Address - Phone:475-265-0696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2269142711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical