# GINA GODEK LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194541359
- **Authorized official:** GINA GODEK LICSW (CLINICAL SOCIAL WORKER)
- **Authorized official phone:** (802) 922-3943

## Contact information

- **Practice address:** 1 KENNEDY DR, SOUTH BURLINGTON, VT 05403-7152
- **Practice address phone:** (802) 922-3943
- **Mailing address:** 22 ARLINGTON GRN, SOUTH BURLINGTON, VT 05403-7001
- **Mailing address phone:** (802) 922-3943

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 12/03/2024
- **Last updated:** 12/03/2024