Individual provider Active NPI

Gabrielle Goddard, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Warren, OH
National Provider Identifier
1548727357
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LCDCII.162147 Issued in OH
Practice address
2430 Parkman Rd NW
Warren, OH 44485-1777
Phone
(330) 469-6822
Fax
(330) 294-5641
NPI assigned
Feb 28, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCDCII.162147 OH Primary

Addresses

Primary practice location

2430 Parkman Rd NW
Warren, OH 44485-1777

Mailing address

158 W Main St
Andover, OH 44003-9318
Phone (216) 800-8700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCDCII.162147OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Safe Harbor Recovery, LLC Substance Abuse Rehabilitation Facility CurrentSince Sep 23, 2024 Accepting new patients
Impact Recovery Services Substance Abuse Rehabilitation Facility CurrentSince Nov 7, 2025 Accepting new patients
First Step Recovery of Warren LLC PastSince May 7, 2024 Accepting new patients
Impact Recovery Services PastSince Nov 7, 2025 Accepting new patients
First Step Recovery of Warren LLC Addiction (Substance Use Disorder) PastSince Sep 8, 2025 Accepting new patients

Locations

158 W Main St
Andover, OH 44003
Phone (216) 800-8700

1212 Tod Pl NW
Warren, OH 44485
Phone (330) 469-6822

2430 Parkman Rd NW
Warren, OH 44485
Phone (330) 469-6822

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/wecaremoreohio/r4/

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1548727357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 W MAIN ST",
            "city": "ANDOVER",
            "state": "OH",
            "postal_code": "440039318",
            "telephone_number": "216-800-8700",
            "fax_number": "216-353-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 PARKMAN RD NW",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444851777",
            "telephone_number": "330-469-6822",
            "fax_number": "330-294-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODDARD",
        "first_name": "GABRIELLE",
        "credential": "CDCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-28",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LCDCII.162147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.