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General NPI Number Information
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NPI Number | 1043166036
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Entity Type | Individual
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Provider Name | MADELINE GOULD LPCC
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Gender | Female
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Dates
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Enumeration Date | 03/10/2026
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Last Update Date | 03/10/2026
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Provider Practice Location Address
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Address Line | 10579 165TH ST W STE B
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City | LAKEVILLE
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State | MN
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Zip | 55044-3536
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Country | US
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Telephone | 612-249-0287
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Fax |
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Provider Business Mailing Address
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Address Line | 3220 GIRARD AVE S APT 107
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City | MINNEAPOLIS
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State | MN
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Zip | 55408-3465
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Country | US
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Telephone | 712-240-0654
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5481
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License Number State | MN
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