MEDICARE: AUDREY SEARFOSS LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	34011968A	IN

General Provider Information

NPI Number	:	1548153513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUDREY SEARFOSS LCSW

Provider Business Mailing Address
First Line	:	52885 QUINCE RD
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46628-9641
Country	:	US
Telephone Number	:	574-904-4671
Fax Number	:

Provider Business Practice Location Address
First Line	:	1402 S MICHIGAN ST
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46613-2214
Country	:	US
Telephone Number	:	574-233-5433
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2025
Last Update Date	:	05/30/2025

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Directions to “ AUDREY SEARFOSS LCSW” Practice Location

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