Provider Demographics
NPI:1518401082
Name:GODBEE, NINA LARYSSA (BA SOCIOLOGY)
Entity Type:Individual
Prefix:MISS
First Name:NINA
Middle Name:LARYSSA
Last Name:GODBEE
Suffix:
Gender:F
Credentials:BA SOCIOLOGY
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1623 KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1209
Mailing Address - Country:US
Mailing Address - Phone:718-375-1200
Mailing Address - Fax:718-676-9411
Practice Address - Street 1:1623 KINGS HWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1209
Practice Address - Country:US
Practice Address - Phone:718-375-1200
Practice Address - Fax:718-676-9411
Is Sole Proprietor?:No
Enumeration Date:2016-12-18
Last Update Date:2016-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker