Elissa May Godfrey

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

0101045768 Issued in VA

Practice address

8119 Holland Rd
Mt Vernon Center
Alexandria, VA 22306-3135

Phone

(703) 360-6910

Fax

(703) 360-0899

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fairfax County, Virginia

  dba Fairfax-Falls Church Community Services Board

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fairfax, VA
  • NPI 1154356244
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361836800000",
    "number": "1134239486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8119 HOLLAND RD",
            "address_2": "MT VERNON CENTER",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223060000",
            "telephone_number": "703-360-6910",
            "fax_number": "703-360-0899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8119 HOLLAND RD",
            "address_2": "MT VERNON CENTER",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223063135",
            "telephone_number": "703-360-6910",
            "fax_number": "703-360-0899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODFREY",
        "first_name": "ELISSA",
        "middle_name": "MAY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101045768",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VA",
            "license": "0101045768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• GM Healthcare LLC
• Gillian Gmitter, LPC, NCC
• Go-Getter Transportation LLC
• God Blessed Medical Care Transp, LLC
• Mary Suzanne Goddard, LCSW
• Richard Godlewski, D.D.S.
• Michele Patrice Godwin, PH.D.
• Rhaea Goff, LCSW
• Alyssa Goggan, MA, LPC, ATR-BC
• Geeti P. Gohari, M.D.

• Child & Adolescent Psychiatry Physician in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Child & Adolescent Psychiatry Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.