Suzannah Miriam Gould, LADAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

4441 Issued in NM

Practice address

Hwy 491 North Pinion Street
Shiprock, NM 87420

Phone

(505) 368-1050

Fax

(505) 368-1437

NPI assigned

Jul 31, 2008

Sex

Female

Sole proprietor

Yes

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": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1972769875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1830",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "874201830",
            "telephone_number": "505-368-1050",
            "fax_number": "505-368-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HWY 491 NORTH PINION STREET",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "87420",
            "telephone_number": "505-368-1050",
            "fax_number": "505-368-1437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001-D West Broadway",
            "address_2": "Presbyterian Medical Services",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "NM",
            "postal_code": "874015638",
            "country_code": "US",
            "telephone_number": "505-325-0238 x8314",
            "fax_number": "505-327-7247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOULD",
        "first_name": "SUZANNAH",
        "middle_name": "MIRIAM",
        "name_prefix": "Ms.",
        "credential": "LADAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-31",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "4441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucy Valentine Gasaway, MSN FNP
• Neil Gholkar, M.D
• James L. Gibson, RN
• Jason Boyd Girouard, CRNA, MSN
• M Martia Glass, MD
• Clinton Kyle Gropp, PHARM D
• Sarah Halimi, OD
• Jimmie L Hall, MSW
• Wendy V. Hall, RN
• Daniel N Hamil, PHARMD

• Addiction (Substance Use Disorder) Counselor in Shiprock, NM
• Providers in Shiprock, NM by specialty
• Addiction (Substance Use Disorder) Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; 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.