Provider Demographics
NPI:1669434304
Name:GODFREY, NAOMI RUTH (LMFT)
Entity type:Individual
Prefix:MRS
First Name:NAOMI
Middle Name:RUTH
Last Name:GODFREY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:NICKIE
Other - Middle Name:RUTH
Other - Last Name:GODFREY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:16055 VENTURA BLVD.
Mailing Address - Street 2:SUITE #1111
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2611
Mailing Address - Country:US
Mailing Address - Phone:818-783-5470
Mailing Address - Fax:818-360-2704
Practice Address - Street 1:16055 VENTURA BLVD.
Practice Address - Street 2:SUITE #1111
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2611
Practice Address - Country:US
Practice Address - Phone:818-783-5470
Practice Address - Fax:818-360-2704
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC7685106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist