Provider Demographics
NPI:1275830705
Name:GOOLD, STEVEN BENJAMIN (MS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:BENJAMIN
Last Name:GOOLD
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 GREAT PLAINS ROAD
Mailing Address - Street 2:
Mailing Address - City:ARAPAHOE
Mailing Address - State:WY
Mailing Address - Zip Code:82510
Mailing Address - Country:US
Mailing Address - Phone:307-349-8564
Mailing Address - Fax:
Practice Address - Street 1:14 GREAT PLAINS ROAD
Practice Address - Street 2:
Practice Address - City:ARAPAHOE
Practice Address - State:WY
Practice Address - Zip Code:82510
Practice Address - Country:US
Practice Address - Phone:307-349-8564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-18
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-1617101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional