Jacqueline S Gould, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

019622-1 Issued in NY

Practice address

104 Happy LN
Ithaca, NY 14850-1304

Phone

(480) 907-4547

NPI assigned

Jun 29, 2010

Last updated

Nov 18, 2011By the provider in NPPES

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1447561030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 HAPPY LN",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501304",
            "telephone_number": "480-907-4547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 HAPPY LN",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501304",
            "telephone_number": "480-907-4547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULD",
        "first_name": "JACQUELINE",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-29",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "019622-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lynn Gorsak, MMS, PA-C
• Graham James Gorsline, DNP CRNA
• Jessica Fleisher Gosa, LMSW
• Jeroen Goulbourne, DO
• Dennis Jay Gould, D.P.M.
• Carole Dense Grady-Mitchell, LPN
• Brian Grafstein, LMT
• Amy Graham, AAS
• Wilfred Bernard Graham, DC
• Lloyd Graves, PT, DPT

• Speech-Language Pathologist in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.