Provider Demographics
NPI:1720262033
Name:BANING, GODFRIED KWAFO (PSYD NCC,LPC, DAPA)
Entity Type:Individual
Prefix:DR
First Name:GODFRIED
Middle Name:KWAFO
Last Name:BANING
Suffix:
Gender:M
Credentials:PSYD NCC,LPC, DAPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 HAMILTON ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-3161
Mailing Address - Country:US
Mailing Address - Phone:732-940-2041
Mailing Address - Fax:732-940-2041
Practice Address - Street 1:821 HAMILTON ST
Practice Address - Street 2:SUITE 1
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3161
Practice Address - Country:US
Practice Address - Phone:732-940-2041
Practice Address - Fax:732-940-2041
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X, 101YS0200X, 103TC1900X
NJ37PC00358500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling