Provider Demographics
NPI:1902283831
Name:APRIL AJAYYA GODSEY, LLC
Entity Type:Organization
Organization Name:APRIL AJAYYA GODSEY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:GODSEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:360-561-4073
Mailing Address - Street 1:8830 TALLON LN NE
Mailing Address - Street 2:SUITE E
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98516-6656
Mailing Address - Country:US
Mailing Address - Phone:360-561-4073
Mailing Address - Fax:360-972-2652
Practice Address - Street 1:8830 TALLON LN NE
Practice Address - Street 2:SUITE E
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98516-6656
Practice Address - Country:US
Practice Address - Phone:360-561-4073
Practice Address - Fax:360-972-2652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60267276251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1467786368Medicaid
1467786368OtherNPI