Provider Demographics
NPI:1457663684
Name:GOULD, ALLENE (LPC)
Entity Type:Individual
Prefix:
First Name:ALLENE
Middle Name:
Last Name:GOULD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 S STATE ST STE V-449
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-3932
Mailing Address - Country:US
Mailing Address - Phone:503-697-8458
Mailing Address - Fax:
Practice Address - Street 1:333 S STATE ST STE V-449
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97034-3932
Practice Address - Country:US
Practice Address - Phone:503-697-8458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-02
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2361101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional