Provider Demographics
NPI:1447971668
Name:GOULD, JULIE (RN, LPC INTERN)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:GOULD
Suffix:
Gender:F
Credentials:RN, LPC INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5702 HARRODS GLEN DR
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-7644
Mailing Address - Country:US
Mailing Address - Phone:502-649-6092
Mailing Address - Fax:
Practice Address - Street 1:10351 LINN STATION RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-3816
Practice Address - Country:US
Practice Address - Phone:502-649-6092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health