Provider Demographics
NPI:1689975849
Name:NWOGU, GODFREY ONYE (M ED)
Entity Type:Individual
Prefix:MR
First Name:GODFREY
Middle Name:ONYE
Last Name:NWOGU
Suffix:
Gender:M
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 MORTON ST
Mailing Address - Street 2:C/O HOPEFOUND MSTAB
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3735
Mailing Address - Country:US
Mailing Address - Phone:617-983-0351
Mailing Address - Fax:866-770-4430
Practice Address - Street 1:170 MORTON ST
Practice Address - Street 2:C/O HOPEFOUND MSTAB
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-3735
Practice Address - Country:US
Practice Address - Phone:617-983-0351
Practice Address - Fax:866-770-4430
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)