Active NPI
Evelyn Gould, PHD BCBA-D
- Clinical Child & Adolescent Psychologist
- Cambridge, MA
National Provider Identifier
1497011365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 31701
- Practice address
- 10 Concord Ave
Cambridge, MA 02138-2322 - Phone
- (781) 462-6988
- Fax
- (833) 756-5677
- NPI assigned
- Apr 5, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 2122 | MA | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 31701 | CA | Primary |
Addresses
Primary practice location
10 Concord Ave
Cambridge, MA 02138-2322
Mailing address
2807 S Sycamore Ave
Los Angeles, CA 90016-3411
Phone (818) 255-8108
Other practice location 1
2807 S Sycamore Ave
Los Angeles, CA 90016-3411
Phone (818) 255-8108
Other practice location 2
612 Main St
Melrose, MA 02176-3116
Phone (781) 462-6988
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2122 | MA | MD | Behavioral Analyst |
| 31701 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594598400000",
"number": "1497011365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2807 S SYCAMORE AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900163411",
"telephone_number": "818-255-8108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 CONCORD AVE",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021382322",
"telephone_number": "781-462-6988",
"fax_number": "833-756-5677"
}
],
"practiceLocations": [
{
"address_1": "2807 S Sycamore Ave",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900163411",
"country_code": "US",
"telephone_number": "818-255-8108",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "612 Main St",
"address_purpose": "LOCATION",
"city": "Melrose",
"state": "MA",
"postal_code": "021763116",
"country_code": "US",
"telephone_number": "781-462-6988",
"fax_number": "833-756-5677",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOULD",
"first_name": "EVELYN",
"name_prefix": "Dr.",
"credential": "PHD BCBA-D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-04-05",
"last_updated": "2020-07-13",
"certification_date": "2020-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MA",
"license": "2122",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "CA",
"license": "31701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.