Provider Demographics
NPI:1851759112
Name:GOULD, LINDA MARIE (LPC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:GOULD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:MARIE
Other - Last Name:DOTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, MA, LPC
Mailing Address - Street 1:1723 ELBERTON HWY
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:GA
Mailing Address - Zip Code:30817-5809
Mailing Address - Country:US
Mailing Address - Phone:762-333-3343
Mailing Address - Fax:
Practice Address - Street 1:400 WALTON WAY
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2438
Practice Address - Country:US
Practice Address - Phone:706-821-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-02
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC012871101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty