Provider Demographics
NPI:1891767950
Name:GODSHALL, FRANK JOSEPH (PHD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:JOSEPH
Last Name:GODSHALL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 COCHRANE CIRCLE
Mailing Address - Street 2:EBHS-3, DBH, EACH
Mailing Address - City:FORT CARSON
Mailing Address - State:CO
Mailing Address - Zip Code:80913
Mailing Address - Country:US
Mailing Address - Phone:719-526-0175
Mailing Address - Fax:
Practice Address - Street 1:7500 COCHRANE CIRCLE
Practice Address - Street 2:EBHS-3, DBH, EACH
Practice Address - City:FORT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913
Practice Address - Country:US
Practice Address - Phone:719-526-0175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY2940103T00000X
WY253103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist