| Melissa L Gould Llc | |
|
205 E University Ave Ste 151 Georgetown TX 78626-6817 | |
| (757) 310-8077 | |
| Not Available |
| Full Name | Melissa L Gould Llc |
|---|---|
| Speciality | Social Worker |
| Location | 205 E University Ave Ste 151, Georgetown, Texas |
| Authorized Official Name and Position | Melissa L Gould (LCSW-S) |
| Authorized Official Contact | 7573108077 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Melissa L Gould Llc 205 E University Ave Ste 151 Georgetown TX 78626-6817 Ph: (757) 310-8077 | Melissa L Gould Llc 205 E University Ave Ste 151 Georgetown TX 78626-6817 Ph: (757) 310-8077 |
| NPI Number | 1174166235 |
|---|---|
| Provider Enumeration Date | 10/22/2019 |
| Last Update Date | 10/22/2019 |
| Medicare PECOS PAC ID | 4688007438 |
|---|---|
| Medicare Enrollment ID | O20191209001600 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174166235 | NPI | - | NPPES |
| 1041C0700X | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Melissa L Gould |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811034929 PECOS PAC ID: 8123321296 Enrollment ID: I20160122001967 |
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