Provider Demographics
NPI:1336759497
Name:GODFREY, HOPE MARIE (COUNSELOR TRAINEE)
Entity type:Individual
Prefix:
First Name:HOPE
Middle Name:MARIE
Last Name:GODFREY
Suffix:
Gender:F
Credentials:COUNSELOR TRAINEE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 VICTORY PKWY FL 1
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-1754
Mailing Address - Country:US
Mailing Address - Phone:513-221-4673
Mailing Address - Fax:
Practice Address - Street 1:4968 GLENWAY AVE STE 215
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-3902
Practice Address - Country:US
Practice Address - Phone:513-853-6575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-04
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2002548-TRNE101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty