Individual
RUSSELL GODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2784 N DECATUR RD, DECATUR, GA 30033-5903
(404) 234-6907
(404) 292-2835
Mailing address
2784 N DECATUR RD STE 145, DECATUR, GA 30033-5903
(404) 234-6907
(404) 292-2835
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW002403
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003181980A
—
GA
Enumeration date
05/20/2015
Last updated
01/20/2017
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