Provider Demographics
NPI:1255907085
Name:DAVID GOGUEN COUNSELING, LLC
Entity type:Organization
Organization Name:DAVID GOGUEN COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GOGUEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:813-748-2824
Mailing Address - Street 1:24459 PAINTER DR
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34639-5461
Mailing Address - Country:US
Mailing Address - Phone:813-748-2824
Mailing Address - Fax:
Practice Address - Street 1:4144 N ARMENIA AVE STE 350
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6434
Practice Address - Country:US
Practice Address - Phone:813-212-8251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health