Healthcare Provider Details

I. General information

NPI: 1508096033
Provider Name (Legal Business Name): PAUL DAVID GOLL JR. MSW LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2009
Last Update Date: 02/09/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 OAK PLZ SUITE 206
ASHEVILLE NC
28801-3008
US

IV. Provider business mailing address

4 CRESTBROOK DR
ARDEN NC
28704-2614
US

V. Phone/Fax

Practice location:
  • Phone: 828-252-2501
  • Fax: 828-252-2701
Mailing address:
  • Phone: 828-582-2279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW016573
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC006770
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: