Timothy D. Gould, ED.D LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CS002646 Issued in MO

Practice address

903 S Kingshighway St
Sikeston, MO 63801-4415

Phone

(573) 979-3676

NPI assigned

May 18, 2006

Last updated

Dec 14, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 14

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• 4-Sight Counseling, Inc.

  • Community/Behavioral Health Agency
  • Cape Girardeau, MO
  • NPI 1427347871
  NPD Authorized official
• 4 Sight Counseling

  • Professional Counselor
  • Cape Girardeau, MO
  • NPI 1801941455
  NPD

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1295788867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 S KINGSHIGHWAY ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638014415",
            "telephone_number": "573-979-3676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 S KINGSHIGHWAY ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638014415",
            "telephone_number": "573-979-3676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "306 Cedar Glen Dr Unit 3D",
            "address_purpose": "LOCATION",
            "city": "Camdenton",
            "state": "MO",
            "postal_code": "650205678",
            "country_code": "US",
            "telephone_number": "573-979-3676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOULD",
        "first_name": "TIMOTHY",
        "middle_name": "D.",
        "credential": "ED.D LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2022-12-14",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": "002646",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "CS002646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPHEALTH",
            "identifier": "431823864",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "493840714",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "156007",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK PPO",
            "identifier": "420291",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREATWEST",
            "identifier": "431823864",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EPOCH",
            "identifier": "49906211",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VETERANS ADMINISTRATION",
            "identifier": "100387",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "11-3764474",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "311575142",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLPOINT",
            "identifier": "431823864",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FORTIS/HL",
            "identifier": "420291",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK/FREEDOM",
            "identifier": "420291",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI ALLIANCE",
            "identifier": "431823864",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "431823864",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Camdenton",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "306 Cedar Glen Dr Unit 3D",
            "city": "Camdenton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "650205678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Professional Counselor in Sikeston, MO
• Providers in Sikeston, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; 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.