CKG Psych Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301016590 Issued in MI

Legal business name

CKG PSYCH INC

Practice address

628 E Parent Ave
Suite 202
Royal Oak, MI 48067-3765

Phone

(510) 214-2544

NPI assigned

Nov 1, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Corie Gould, PSY.D.

Title

Owner/Licensed Psychologist

Phone

(406) 698-2722

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1477958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477958400000",
    "number": "1013469410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 E PARENT AVE",
            "address_2": "SUITE 202",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480673765",
            "telephone_number": "510-214-2544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 E PARENT AVE",
            "address_2": "SUITE 202",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480673765",
            "telephone_number": "510-214-2544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CKG PSYCH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-01",
        "last_updated": "2016-11-01",
        "status": "A",
        "authorized_official_last_name": "GOULD",
        "authorized_official_first_name": "CORIE",
        "authorized_official_title_or_position": "OWNER/LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "406-698-2722",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301016590",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301016590",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Logan Danielle Cipponeri, DPT
• Citizens Home Care, Inc.
• City of Royal Oak (Royal Oak Fire Department)
• City Urgent Care PC
• Courtney Leigh Ciullo, NP-C
• Claire Peeples, MD, PLLC (Claire Peeples, M.D.)
• Carly Peyton Clark, M.A., CF-SLP
• Carol Clark
• Courtney A Clark, CRNA
• Donald Clark, LMSW

• Clinical Psychologist in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.