Provider Demographics
NPI:1548658123
Name:GODDARD, ANNA BAUGUESS (LPC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:BAUGUESS
Last Name:GODDARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:KIRSTEN
Other - Last Name:BAUGUESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1 ZILLICOA ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-1038
Mailing Address - Country:US
Mailing Address - Phone:828-260-1670
Mailing Address - Fax:
Practice Address - Street 1:1 ZILLICOA ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1038
Practice Address - Country:US
Practice Address - Phone:828-260-1670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-05
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7484101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional