Provider Demographics
NPI:1932170016
Name:GOLD, MARCEY MILLER (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:MARCEY
Middle Name:MILLER
Last Name:GOLD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 NEEDLEWOOD LOOP
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-6471
Mailing Address - Country:US
Mailing Address - Phone:407-366-9662
Mailing Address - Fax:407-971-0266
Practice Address - Street 1:1000 EXECUTIVE DR
Practice Address - Street 2:SUITE 9
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8140
Practice Address - Country:US
Practice Address - Phone:407-971-6866
Practice Address - Fax:407-971-0266
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4101101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ8195OtherBLUE CROSS BLUE SHIELD
18810OtherAMERIGROUP
62 31311OtherUNITED HEALTH CARE