Provider Demographics
NPI:1336630425
Name:GODLEWSKI, SARAH (LPC, LMHC-D)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GODLEWSKI
Suffix:
Gender:F
Credentials:LPC, LMHC-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 HANSHAW RD STE A
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-1548
Mailing Address - Country:US
Mailing Address - Phone:971-319-1672
Mailing Address - Fax:866-598-3922
Practice Address - Street 1:832 HANSHAW RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1548
Practice Address - Country:US
Practice Address - Phone:971-319-1672
Practice Address - Fax:866-598-3922
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2024-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10002551101YM0800X
ARA1909027101YM0800X
ARP2101130101YM0800X
NY013927101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health