Individual provider Active NPI

Merle Jenaii Gold, PH.D., MFT

  • Mental Health Counselor
  • Sebastopol, CA
National Provider Identifier
1962521088
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MFC 22914 Issued in CA
Practice address
7550 Healdsburg Ave
Sebastopol, CA 95472-3325
Phone
(707) 823-8541
Fax
(707) 823-8541
NPI assigned
Mar 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MFC 22914 CA Primary

Addresses

Primary practice location

7550 Healdsburg Ave
Sebastopol, CA 95472-3325

Mailing address

7550 Healdsburg Ave
Sebastopol, CA 95472-3325
Phone (707) 823-8541

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

LicenseStateTypeSpecialty
MFC 22914CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962521088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7550 HEALDSBURG AVE",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954723325",
            "telephone_number": "707-823-8541",
            "fax_number": "707-823-8541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7550 HEALDSBURG AVE",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954723325",
            "telephone_number": "707-823-8541",
            "fax_number": "707-823-8541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLD",
        "first_name": "MERLE",
        "middle_name": "JENAII",
        "name_prefix": "Dr.",
        "credential": "PH.D., MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFC 22914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastopol, CA

Sources for this page

  • 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.