Individual provider Active NPI

Marilyn Powell Godette, LCSW

  • Clinical Social Worker
  • Fayetteville, NC
National Provider Identifier
1710057278
Registry record updated Jan 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C001797 Issued in NC
Practice address
2520 Murchison Rd
Fayetteville, NC 28301-3566
Phone
(910) 580-0345
Fax
(910) 488-7487
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C001797 NC Primary

Addresses

Primary practice location

2520 Murchison Rd
Fayetteville, NC 28301-3566

Mailing address

PO Box 984
2520 Murchison Road Suite 7-a
Fayetteville, NC 28302-0984
Phone (910) 580-0345

Other identifiers 1

IdentifierTypeStateIssuer
6003385MedicaidNC

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
C001797NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Treatment & Consulting Services LLC PastSince Jun 12, 2007 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389225600000",
    "number": "1710057278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 984",
            "address_2": "2520 MURCHISON ROAD SUITE 7-A",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283020984",
            "telephone_number": "910-580-0345",
            "fax_number": "910-488-7487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 MURCHISON RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283013566",
            "telephone_number": "910-580-0345",
            "fax_number": "910-488-7487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODETTE",
        "first_name": "MARILYN",
        "middle_name": "POWELL",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2014-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C001797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6003385",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2014; 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.