Provider Demographics
NPI:1538677513
Name:GOLD, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:GOLD
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:DOVID
Other - Middle Name:
Other - Last Name:GOLD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:245 PASSAIC AVE APT E9
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-3622
Mailing Address - Country:US
Mailing Address - Phone:973-870-8200
Mailing Address - Fax:
Practice Address - Street 1:1592B UNION VALLEY RD
Practice Address - Street 2:
Practice Address - City:WEST MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07480-1337
Practice Address - Country:US
Practice Address - Phone:973-657-1222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-12
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00611700101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional