Elizabeth Gould, Marriage & Family Therapist, Inc.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC32388 Issued in CA

Legal business name

ELIZABETH GOULD, MARRIAGE & FAMILY THERAPIST, INC.

Practice address

4170 Admiralty Way
Suite 405
Marina del Rey, CA 90292-4618

Phone

(310) 578-5957

Fax

(310) 827-2294

NPI assigned

Oct 10, 2007

Last updated

May 11, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elizabeth Gould, M.A., M.F.T.

Title

Owner

Phone

(310) 578-5957

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305072000000",
    "number": "1114115540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4170 ADMIRALTY WAY",
            "address_2": "SUITE 405",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902924618",
            "telephone_number": "310-578-5957",
            "fax_number": "310-827-2294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4170 ADMIRALTY WAY",
            "address_2": "SUITE 405",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902924618",
            "telephone_number": "310-578-5957",
            "fax_number": "310-827-2294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH GOULD, MARRIAGE & FAMILY THERAPIST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-10",
        "last_updated": "2011-05-11",
        "status": "A",
        "authorized_official_last_name": "GOULD",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-578-5957",
        "authorized_official_credential": "M.A., M.F.T."
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC32388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1306902754",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2011; 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.