Provider Demographics
NPI:1619185030
Name:GOULD, DAVYE (LICSW)
Entity Type:Individual
Prefix:
First Name:DAVYE
Middle Name:
Last Name:GOULD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:DAVYE
Other - Middle Name:
Other - Last Name:GOULD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:1234 19TH ST NW
Mailing Address - Street 2:SUITE 901
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-2407
Mailing Address - Country:US
Mailing Address - Phone:202-232-1279
Mailing Address - Fax:
Practice Address - Street 1:1234 19TH ST NW
Practice Address - Street 2:SUITE 901
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-2407
Practice Address - Country:US
Practice Address - Phone:202-232-1279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3019671041C0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist