Healthcare Provider Details

I. General information

NPI: 1477353191
Provider Name (Legal Business Name): DAVID GOSS BA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2025
Last Update Date: 03/13/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HCRC HEALTH RESOURCE CENTER 23 BRADSTON STREET
BOSTON MA
02118
US

IV. Provider business mailing address

HCRC HEALTH RESOURCE CENTER 23 BRADSTON STREET
BOSTON MA
02118
US

V. Phone/Fax

Practice location:
  • Phone: 617-318-6480
  • Fax:
Mailing address:
  • Phone: 617-318-6480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: