Provider Demographics
NPI:1962470500
Name:GOULD, LINDA C (PCC-S)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:C
Last Name:GOULD
Suffix:
Gender:F
Credentials:PCC-S
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:C
Other - Last Name:GOULD-FABER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PCC
Mailing Address - Street 1:12894 WESTCHESTER TRL
Mailing Address - Street 2:
Mailing Address - City:CHESTERLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44026-2838
Mailing Address - Country:US
Mailing Address - Phone:440-729-6229
Mailing Address - Fax:440-729-6224
Practice Address - Street 1:8398 KINSMAN RD
Practice Address - Street 2:
Practice Address - City:NOVELTY
Practice Address - State:OH
Practice Address - Zip Code:44072-9418
Practice Address - Country:US
Practice Address - Phone:216-462-0528
Practice Address - Fax:216-765-0158
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-09
Last Update Date:2020-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0001016101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health