Provider Demographics
NPI:1104410737
Name:GODSEY, RHEA LAUREN (LICSW)
Entity type:Individual
Prefix:
First Name:RHEA
Middle Name:LAUREN
Last Name:GODSEY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9801 APOLLO DR UNIT 7261
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20792-5555
Mailing Address - Country:US
Mailing Address - Phone:301-821-3861
Mailing Address - Fax:
Practice Address - Street 1:1200 1ST ST NE FL 9
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-7953
Practice Address - Country:US
Practice Address - Phone:202-442-7111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD179291041C0700X
DCLC500822691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical