Qusayy M. Godbolt

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

QUSAYY M. GODBOLT

Doing business as

Godbolt Behavioral Consulting

Practice address

1207 Snowball LN
Clarksville, TN 37042-7855

Phone

(931) 378-4751

NPI assigned

Aug 28, 2019

Last updated

Aug 28, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amanda Walker

Title

Administrator

Phone

(817) 938-0823

Specialties & licenses 1

Addresses

Other names 1

• Godbolt Behavioral Consulting Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Qusayy M Godbolt, PH.D, BCBA-D

  • Behavior Analyst
  • Clarksville, TN
  • NPI 1740504398
  NPD

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566950400000",
    "number": "1497303960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 SNOWBALL LN",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370427855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 SNOWBALL LN",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370427855",
            "telephone_number": "931-378-4751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUSAYY M. GODBOLT",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-28",
        "last_updated": "2019-08-28",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "817-938-0823"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Godbolt Behavioral Consulting",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Behavior Analyst in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Behavior Analyst in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; 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.