Individual provider Active NPI

Jennifer Agnes Gould, MA, LPC, NCC

  • Mental Health Counselor
  • Medford, NJ
National Provider Identifier
1447750641
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
37AC00403000 Issued in NJ
Practice address
11 Chairville Rd
Medford, NJ 08055-9619
Phone
(609) 388-8919
NPI assigned
Feb 15, 2018
Last updated
Jul 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PC013288 PA
Mental Health Counselor 101YM0800X 37AC00403000 NJ Primary

Addresses

Primary practice location

11 Chairville Rd
Medford, NJ 08055-9619

Mailing address

11 Chairville Rd
Medford, NJ 08055-9619
Phone (609) 975-3250

Other names 1

  • Mrs. Jennifer Agnes Gergely Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
37AC00403000NJMDMental Health Counselor
PC013288PAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Haddonfield Psychiatry, LLC Mental Health CurrentSince Aug 23, 2020 Accepting new patients
Chairville Counseling Mental Health CurrentSince Apr 9, 2024 Accepting new patients

Locations

30 Washington Ave
Ste E1
Haddonfield, NJ 08033
Phone (856) 300-2661

11 Chairville Rd
Medford, NJ 08055
Phone (609) 388-8919

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1518652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1447750641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CHAIRVILLE RD",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080559619",
            "telephone_number": "609-975-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CHAIRVILLE RD",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080559619",
            "telephone_number": "609-388-8919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULD",
        "first_name": "JENNIFER",
        "middle_name": "AGNES",
        "name_prefix": "Mrs.",
        "credential": "MA, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-15",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC013288",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37AC00403000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "GERGELY",
            "middle_name": "AGNES",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Medford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; 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.