Provider Demographics
NPI:1720598790
Name:GOLD, ABIGAIL IRENE SALOMON (LPC)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:IRENE SALOMON
Last Name:GOLD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:938 DANISH DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-2315
Mailing Address - Country:US
Mailing Address - Phone:972-824-2541
Mailing Address - Fax:
Practice Address - Street 1:4841 MERLOT AVE UNIT 420
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-7382
Practice Address - Country:US
Practice Address - Phone:817-809-8399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-04
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67470101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional