| Doctor Name: | MRS. SHANDA NICOLE COLLINS-GODETTE |
| NPI Number: | 1891934113 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW, LCAS, P-LCSW |
| License Number: | 1335 |
| Business Practice Address: | 560 Fisher Town Rd Havelock, NC - 285328964 |
| Business Phone Number: | 2522293113 |
| Business Fax Number: | 2524471986 |
| Mailing Address: | 560 Fisher Town Rd, HAVELOCK |
| State: | NC |
| Postal Code: | 285328964 |
| Phone Number: | 2522293113 |
| Fax Number: | 2524471986 |
| NPI Enumeration Date: | 02/10/2009 |
| NPI Last Update Date: | 02/10/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 1335 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |