Individual
AUDREY S GODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
4401 W WESTERN AVE STE C, SOUTH BEND, IN 46619-2645
(574) 725-7006
(574) 807-9614
Mailing address
59877 MIDDLEBORO ST, SOUTH BEND, IN 46614-3625
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
39003682A
IN
Other
Enumeration date
04/05/2016
Last updated
06/25/2025
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