Provider Demographics
NPI:1134553282
Name:GODOY, RICHARD ANTHONY (LCSW)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:ANTHONY
Last Name:GODOY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 TEASLEY LN
Mailing Address - Street 2:SUITE #243
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-7946
Mailing Address - Country:US
Mailing Address - Phone:940-539-9917
Mailing Address - Fax:940-539-9917
Practice Address - Street 1:1308 TEASLEY LN
Practice Address - Street 2:SUITE # 243
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-7946
Practice Address - Country:US
Practice Address - Phone:940-539-9917
Practice Address - Fax:940-539-9917
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-26
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX281351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical