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General NPI Number Information
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NPI Number | 1811443013
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Entity Type | Organization
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Legal Business Name | MIRIAM GOLD LCSW, PLLC
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 08/28/2016
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Provider Practice Location Address
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Address Line | 4913 PROFESSIONAL CT SUITE 5
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City | RALEIGH
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State | NC
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Zip | 27609-4913
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Country | US
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Telephone | 919-638-3946
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Fax |
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Provider Business Mailing Address
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Address Line | 743 WEATHERGREEN DR
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City | RALEIGH
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State | NC
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Zip | 27615-3224
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Country | US
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Telephone | 919-673-6298
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MS. MIRIAM SUE GOLD
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Credential | MSW LCSW
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Telephone | 919-638-3946
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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