Jacquelyn Susan Gould, LISW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I-0005692 SUPV Issued in OH

Practice address

22001 Fairmount Blvd
University Heights, OH 44118-4819

Phone

(216) 320-8315

Fax

(216) 320-6446

NPI assigned

Dec 15, 2010

Last updated

Dec 15, 2010By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292371200000",
    "number": "1962705814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22001 FAIRMOUNT BLVD",
            "city": "UNIVERSITY HEIGHTS",
            "state": "OH",
            "postal_code": "441184819",
            "telephone_number": "216-320-8315",
            "fax_number": "216-320-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22001 FAIRMOUNT BLVD",
            "city": "UNIVERSITY HEIGHTS",
            "state": "OH",
            "postal_code": "441184819",
            "telephone_number": "216-320-8315",
            "fax_number": "216-320-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULD",
        "first_name": "JACQUELYN",
        "middle_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-15",
        "last_updated": "2010-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I-0005692 SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan Gecht, LPC
• Amanda Giddens
• Robert Melvin Gilmore
• Ivan Glagola
• Adi Goldberg, MS, RD
• Esther Graber
• Farah Joy Grandalski, PHARMD
• Brittany Haddad
• Jasmine Briana Hamilton, DDS
• Christina Hampton

• Clinical Social Worker in University Heights, OH
• Providers in University Heights, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; 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.