Provider Demographics
NPI:1588486161
Name:GOLD, AUBREY (LPC, NCC)
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:
Last Name:GOLD
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:752 FITZROY DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-0790
Mailing Address - Country:US
Mailing Address - Phone:770-870-7655
Mailing Address - Fax:
Practice Address - Street 1:598 S MILLEDGE AVE STE 5
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-1262
Practice Address - Country:US
Practice Address - Phone:770-676-1868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC015185101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health