Mark A Gould, PH D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

002277 Issued in CT

Practice address

401 West Thames Street
Southeastern Mental Health Authority BLDG 301
Norwich, CT 06360

Phone

(860) 859-4674

Fax

(860) 859-4790

NPI assigned

Nov 15, 2006

Sex

Male

Sole proprietor

No

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

Credentials

Doctor of Philosophy

State licenses

Practice roles

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

• State of Connecticut

  • Skilled Nursing Facility
  • Rocky Hill, CT
  • NPI 1205951662
  NPD (past)
• State of Connecticut

  • Adult Mental Health Clinic/Center
  • Norwich, CT
  • NPI 1902831548
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811060221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 WEST THAMES STREET",
            "address_2": "SOUTHEASTERN MENTAL HEALTH AUTHORITY BLDG 301",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "06360",
            "telephone_number": "860-859-4674",
            "fax_number": "860-859-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 WEST THAMES STREET",
            "address_2": "SOUTHEASTERN MENTAL HEALTH AUTHORITY BLDG 301",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "06360",
            "telephone_number": "860-859-4674",
            "fax_number": "860-859-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULD",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "002277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yvonne Marie Gordon-Moser, LPCA
• Eric John Gorham
• Gorin'S Furniture Inc
• Sharon Gosselin
• Debra Gottschalk
• Richard Goulding, MD
• Ashley Goulet, APRN
• Hanady Gouta
• Rama Goyal, MD PA
• Samantha Graham

• Psychologist in Norwich, CT
• Providers in Norwich, CT by specialty
• Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.