MEDICARE: NARONN GODDARD SR. QMHS

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1720975717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NARONN GODDARD SR. QMHS

Provider Business Mailing Address
First Line	:	7813 N DIXIE DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45414-2719
Country	:	US
Telephone Number	:	937-422-2311
Fax Number	:

Provider Business Practice Location Address
First Line	:	7813 N DIXIE DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45414-2719
Country	:	US
Telephone Number	:	937-422-2311
Fax Number	:

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

Provider Enumeration Date	:	06/21/2025
Last Update Date	:	06/23/2025

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