Individual provider Active NPI

Nicole Godfrey, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Charleston, SC
National Provider Identifier
1265387534
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
31605 Issued in SC
Practice address
4 Carriage LN Ste 200
Charleston, SC 29407-6049
Phone
(843) 266-7573
NPI assigned
Mar 3, 2026
Last updated
Mar 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 31605 SC Primary

Addresses

Primary practice location

4 Carriage LN Ste 200
Charleston, SC 29407-6049

Mailing address

200 Foxcroft LN
Moncks Corner, SC 29461-6892

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
31605SCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Myndspace Mental Health Education & Consulting, LLC Psychiatric/Mental Health PastSince Mar 21, 2021 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25144/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1772496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1265387534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 FOXCROFT LN",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294616892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CARRIAGE LN STE 200",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294076049",
            "telephone_number": "843-266-7573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODFREY",
        "first_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-03",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "31605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2026; 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.