Provider Demographics
NPI:1427207406
Name:GODSEY, PAMELA J (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:J
Last Name:GODSEY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46203-1939
Mailing Address - Country:US
Mailing Address - Phone:317-633-4666
Mailing Address - Fax:317-633-4671
Practice Address - Street 1:1308 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46203-1939
Practice Address - Country:US
Practice Address - Phone:317-633-4666
Practice Address - Fax:317-633-4671
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005079A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical