Provider Demographics
NPI:1609609924
Name:GOULD, SHERRY (LPC-ASSOI)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:GOULD
Suffix:
Gender:F
Credentials:LPC-ASSOI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31306 BERMAR ST
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77355-3744
Mailing Address - Country:US
Mailing Address - Phone:346-813-6609
Mailing Address - Fax:
Practice Address - Street 1:31306 BERMAR ST
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77355-3744
Practice Address - Country:US
Practice Address - Phone:346-813-6609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96163101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional