Nefertiti K Khemet Goudjayi, LCSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

102830 Issued in CA

Practice address

5329 48TH Ave S Unit 128
Minneapolis, MN 55417-3701

Phone

(916) 243-5337

NPI assigned

Jul 28, 2014

Last updated

Aug 19, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Solfull River Counseling LLC

  • Social Worker
  • Minneapolis, MN
  • NPI 1447125570
  NPD Authorized official
• Beyond Bars a Restorative Justice Center

  dba N/a

  • Social Worker
  • Sacramento, CA
  • NPI 1124730460
  Authorized official Same address or phone

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1275941775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5329 48TH AVE S UNIT 128",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554173701",
            "telephone_number": "916-243-5337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5329 48TH AVE S UNIT 128",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554173701",
            "telephone_number": "916-243-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHEMET GOUDJAYI",
        "first_name": "NEFERTITI",
        "middle_name": "K",
        "credential": "LCSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "32064",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "61311533",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "102830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farid Khasiyev, M.D.
• Pratibha Khatiwoda
• Zoha Khatoon, DMD
• Sarah Khayutin, PHD, LP
• Kheir Home Health Services Inc
• Anastasia Khenkin
• Francisca Kho
• Connie Lee Khong, PHARMD
• Shun Yi Khor, DDS
• Ameer Ali Khowaja, M.D.

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.