Individual provider Active NPI

Aaron John Godlaski, PHD

  • Clinical Psychologist
  • Lexington, KY
National Provider Identifier
1326688946
Registry record updated Jan 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
251300 Issued in KY
Practice address
535 W Second St Ste 207
Lexington, KY 40508-1268
Phone
(859) 255-4864
NPI assigned
Jan 11, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 251300 KY Primary

Addresses

Primary practice location

535 W Second St Ste 207
Lexington, KY 40508-1268

Mailing address

202 Arlington Ave
Lexington, KY 40508-2708
Phone (859) 333-6513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 20, 2020 through Feb 20, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
251300KYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1578700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578700800000",
    "number": "1326688946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 ARLINGTON AVE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405082708",
            "telephone_number": "859-333-6513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 W SECOND ST STE 207",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405081268",
            "telephone_number": "859-255-4864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODLASKI",
        "first_name": "AARON",
        "middle_name": "JOHN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-11",
        "last_updated": "2020-01-11",
        "certification_date": "2020-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "251300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.