Provider Demographics
NPI:1720262900
Name:GODSEY, JOAN HUNTER (MSW)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:HUNTER
Last Name:GODSEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:HUNTER
Other - Last Name:GODSEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:2809 WASHINGTON AVE
Mailing Address - Street 2:STE R
Mailing Address - City:BEDFORD
Mailing Address - State:IN
Mailing Address - Zip Code:47421-5310
Mailing Address - Country:US
Mailing Address - Phone:812-278-8707
Mailing Address - Fax:877-366-6099
Practice Address - Street 1:2809 WASHINGTON AVE
Practice Address - Street 2:STE R
Practice Address - City:BEDFORD
Practice Address - State:IN
Practice Address - Zip Code:47421-5310
Practice Address - Country:US
Practice Address - Phone:812-278-8707
Practice Address - Fax:877-366-6099
Is Sole Proprietor?:No
Enumeration Date:2007-12-24
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN104100000X
IN34006152A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker