Provider Demographics
NPI:1518241553
Name:GODIN, JENNIFER MARIE (LICSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIE
Last Name:GODIN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 NASHUA RD STE B2
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3419
Mailing Address - Country:US
Mailing Address - Phone:603-818-8926
Mailing Address - Fax:603-818-8928
Practice Address - Street 1:80 NASHUA RD STE B2
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3419
Practice Address - Country:US
Practice Address - Phone:603-818-8926
Practice Address - Fax:603-818-8928
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH19721041C0700X
104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker