Provider Demographics
NPI:1003188178
Name:DOUGLAS L. GOSNEY
Entity Type:Organization
Organization Name:DOUGLAS L. GOSNEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOSNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MFT
Authorized Official - Phone:310-867-5349
Mailing Address - Street 1:2566 OVERLAND AVE
Mailing Address - Street 2:SUITE 780
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-3366
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2566 OVERLAND AVE
Practice Address - Street 2:SUITE 780
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-3366
Practice Address - Country:US
Practice Address - Phone:310-202-9382
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-03
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty