Provider Demographics
NPI:1154661890
Name:GOULD, PATRICK JOSEPH (LMHC)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:JOSEPH
Last Name:GOULD
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3249 BERNATH DR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32583-8455
Mailing Address - Country:US
Mailing Address - Phone:850-972-8763
Mailing Address - Fax:
Practice Address - Street 1:6425 PENSACOLA BLVD STE 1-3
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32505-1701
Practice Address - Country:US
Practice Address - Phone:850-471-0017
Practice Address - Fax:850-215-6003
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14665101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health