Tristen M Gould, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

8861342 Issued in ID

Practice address

1620 Northwest Blvd Ste 101
Coeur D Alene, ID 83814-2488

Phone

(208) 512-5085

NPI assigned

Jun 2, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cultivation, LLC

  • Community/Behavioral Health Agency
  • Coeur D'Alene, ID
  • NPI 1124466990
  NPD (past)
• Empowered Through Play LLC

  • Mental Health Counselor
  • Coeur D Alene, ID
  • NPI 1033588207
  NPD (past)

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

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1053935304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 NORTHWEST BLVD STE 101",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142488",
            "telephone_number": "208-512-5085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 NORTHWEST BLVD STE 101",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142488",
            "telephone_number": "208-512-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULD",
        "first_name": "TRISTEN",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-02",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "8861342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aimee M Goold, ARNP, FNP-BC
• John Edward Gordon, M.D.
• Kasie Dawn Gordon, MP
• Ashley A Gorham, LD
• Amanda Goulart
• Janet M Gourley, DNP, NP
• Peter Gordon Gourley, ARNP
• Grace Ridge Counseling
• Kelly Grace, LMP
• Nicholas Graham

• Social Worker in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.