Provider Demographics
NPI:1033346960
Name:GOULD, KRISTIN D (MED, CAGS)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:D
Last Name:GOULD
Suffix:
Gender:F
Credentials:MED, CAGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 NEWFIELD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-1711
Mailing Address - Country:US
Mailing Address - Phone:978-808-8802
Mailing Address - Fax:
Practice Address - Street 1:45 MERRIMACK ST
Practice Address - Street 2:#200
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1729
Practice Address - Country:US
Practice Address - Phone:978-459-2306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health