Provider Demographics
NPI:1982834453
Name:OKEORJI, SAMUEL GODWIN (MSW)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:GODWIN
Last Name:OKEORJI
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:MR
Other - First Name:SAMUEL
Other - Middle Name:CHIBUIKE
Other - Last Name:GODWIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:55 TIMOTHY TER
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-1653
Mailing Address - Country:US
Mailing Address - Phone:860-219-0449
Mailing Address - Fax:
Practice Address - Street 1:55 TIMOTHY TER
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-1653
Practice Address - Country:US
Practice Address - Phone:860-219-0449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-19
Last Update Date:2009-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)