Provider Demographics
NPI:1962640185
Name:GOULD, DEBBIE WARSHAW (MS, LCSW)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:WARSHAW
Last Name:GOULD
Suffix:
Gender:F
Credentials:MS, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1244 PINE ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-4809
Mailing Address - Country:US
Mailing Address - Phone:303-906-6145
Mailing Address - Fax:
Practice Address - Street 1:1244 PINE ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-4809
Practice Address - Country:US
Practice Address - Phone:303-906-6145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-26
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO991167101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
64-095992OtherEIN #