Provider Demographics
NPI:1245012087
Name:GODINHO, ELIZABETH JANEL (LSW)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:JANEL
Last Name:GODINHO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2212 LYNN DRIVE
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:IL
Mailing Address - Zip Code:60538
Mailing Address - Country:US
Mailing Address - Phone:630-945-0082
Mailing Address - Fax:
Practice Address - Street 1:113 MAIN STREET
Practice Address - Street 2:STE. 302
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543
Practice Address - Country:US
Practice Address - Phone:630-733-9108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-17
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.111722104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker