Individual
DR. JOHN PHILLIP GODFREY
Active
Individual
DR. JOHN PHILLIP GODFREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
25101
TX
103TA0700X
Adult Development & Aging Psychologist
25101
TX
103TB0200X
Cognitive & Behavioral Psychologist
25101
TX
103TC0700X
Clinical Psychologist
Primary
25101
TX
103TC2200X
Clinical Child & Adolescent Psychologist
25101
TX
103TF0000X
Family Psychologist
25101
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0003LJ
BCBS NUMBER
TX
05
—
040973202
—
TX
01
—
160306
VALUE OPTIONS
TX
01
—
97034000
MAGELLAN ID NUMBER
TX
Enumeration date
08/11/2006
Last updated
04/27/2023
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