Patricia Ann Black-Gould, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

300905 Issued in ME

Practice address

10116 Bittern Dr # 32507
Pensacola, FL 32507-7208

Phone

(207) 890-5243

NPI assigned

Oct 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1710072590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3298 SUMMIT BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325038318",
            "telephone_number": "850-860-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10116 BITTERN DR # 32507",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325077208",
            "telephone_number": "207-890-5243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK-GOULD",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-07-10",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ME",
            "license": "300905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL SECURITY #",
            "identifier": "$$$$$$$$$",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Pensacola, FL
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.

Verify at the official NPI Registry.