Provider Demographics
NPI:1801493358
Name:GODFREY, MICHAELA (MS)
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:
Last Name:GODFREY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3443 ESPLANADE AVE APT 116
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-2937
Mailing Address - Country:US
Mailing Address - Phone:662-816-8767
Mailing Address - Fax:
Practice Address - Street 1:1615 POYDRAS ST STE 900
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-1282
Practice Address - Country:US
Practice Address - Phone:504-233-9860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health