Provider Demographics
NPI:1568160125
Name:GODFREY, TELIA RASHAUN (MA, LMHP-RESIDENT)
Entity Type:Individual
Prefix:
First Name:TELIA
Middle Name:RASHAUN
Last Name:GODFREY
Suffix:
Gender:F
Credentials:MA, LMHP-RESIDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 S MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24426-2032
Mailing Address - Country:US
Mailing Address - Phone:540-965-6468
Mailing Address - Fax:540-965-9268
Practice Address - Street 1:916 S MONROE AVE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:VA
Practice Address - Zip Code:24426-2032
Practice Address - Country:US
Practice Address - Phone:540-965-6468
Practice Address - Fax:540-965-9268
Is Sole Proprietor?:No
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional