Provider Demographics
NPI:1801082128
Name:M GOULD THERAPY INC.
Entity type:Organization
Organization Name:M GOULD THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:PATRICE
Authorized Official - Last Name:GOULD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:561-630-9321
Mailing Address - Street 1:600 SANDTREE DR
Mailing Address - Street 2:206B
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33403-1597
Mailing Address - Country:US
Mailing Address - Phone:561-630-9321
Mailing Address - Fax:561-790-6940
Practice Address - Street 1:600 SANDTREE DR
Practice Address - Street 2:206B
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33403-1597
Practice Address - Country:US
Practice Address - Phone:561-630-9321
Practice Address - Fax:561-790-6940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2975Medicare PIN