Provider Demographics
NPI:1508233586
Name:GOLD, DANA (MAC, LPC, CCTP)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:GOLD
Suffix:
Gender:F
Credentials:MAC, LPC, CCTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:296 W RIDGE PIKE
Mailing Address - Street 2:
Mailing Address - City:LIMERICK
Mailing Address - State:PA
Mailing Address - Zip Code:19468-1790
Mailing Address - Country:US
Mailing Address - Phone:484-902-8143
Mailing Address - Fax:
Practice Address - Street 1:296 W RIDGE PIKE STE 202
Practice Address - Street 2:
Practice Address - City:LIMERICK
Practice Address - State:PA
Practice Address - Zip Code:19468-1790
Practice Address - Country:US
Practice Address - Phone:484-902-8143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-26
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010945101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional