Provider Demographics
NPI:1366565046
Name:GODDARD, KAREN E (LICSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:E
Last Name:GODDARD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:179 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-6021
Mailing Address - Country:US
Mailing Address - Phone:774-264-1514
Mailing Address - Fax:508-828-9146
Practice Address - Street 1:ONE WASHINGTON STREET
Practice Address - Street 2:MILL RIVER PROFESSIONAL CENTER
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780
Practice Address - Country:US
Practice Address - Phone:508-828-9116
Practice Address - Fax:508-828-9146
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1160901041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical