Melissa L Gould LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MELISSA L GOULD LLC

Practice address

205 E University Ave Ste 151
Georgetown, TX 78626-6817

Phone

(757) 310-8077

NPI assigned

Oct 22, 2019

Organization subpart

No

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

Authorized official

Name

Melissa L GouldNPI 1811034929

Title

LCSW-S

Phone

(757) 310-8077

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Melissa Lee Gould, MSW

  • Clinical Social Worker
  • Travis Afb, CA
  • NPI 1811034929

  TX

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1571702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571702400000",
    "number": "1174166235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E UNIVERSITY AVE STE 151",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786266817",
            "telephone_number": "757-310-8077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E UNIVERSITY AVE STE 151",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786266817",
            "telephone_number": "757-310-8077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELISSA L GOULD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-22",
        "last_updated": "2019-10-22",
        "status": "A",
        "authorized_official_last_name": "GOULD",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "LCSW-S",
        "authorized_official_telephone_number": "757-310-8077"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1041C0700X",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Medsur One Telemedicine LLC
• Deborah Meeker, P.T.
• Anya Meeks
• Sammie Mees, DC
• Adam Melcher
• Mary Mellencamp
• Ellen Clarice Melton, PHD, LPC
• Travis Mendenhall
• Devina Monique Mendez, PTA
• Crystal Maddox Mendl, RN

• Clinical Social Worker in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.