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NPI Code Detail

MEDICARE: MRS. BRIELLE REBEKAH GOULD LCSW

MEDICARE: MRS. BRIELLE REBEKAH GOULD LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCSW005436GA

General Provider Information

NPI Number : 1427430701
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRIELLE REBEKAH GOULD LCSW
Provider Business Mailing Address
First Line : 3495 PIEDMONT RD NE
Second Line : NINE PIEDMONT CENTER
City : ATLANTA
State : GA
Zip : 30305-1717
Country : US
Telephone Number : 404-364-7070
Fax Number :
Provider Business Practice Location Address
First Line : 1100 LAKE HEARN DR STE 250&500
Second Line : KAISER PERMANENTE SANDY SPRINGS MEDICAL OFFICE
City : SANDY SPRINGS
State : GA
Zip : 30342-1523
Country : US
Telephone Number : 404-845-4500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2015
Last Update Date : 01/10/2022

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