Healthcare Provider Details

I. General information

NPI: 1518622125
Provider Name (Legal Business Name): OLETHA HOPE GOULD LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2021
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 ENTERPRISE RD
SOCORRO NM
87801-4199
US

IV. Provider business mailing address

1300 ENTERPRISE RD
SOCORRO NM
87801-4199
US

V. Phone/Fax

Practice location:
  • Phone: 575-835-4444
  • Fax:
Mailing address:
  • Phone: 575-835-4444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCTB-2025-0436
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: