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NPI Code Detail

MEDICARE: KYLE GOULD

MEDICARE: KYLE GOULD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor
2171M00000XCase Manager/Care Coordinator
3172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1811789043
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLE GOULD
Provider Business Mailing Address
First Line : 3500 CARNEGIE AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-2641
Country : US
Telephone Number : 440-260-6835
Fax Number :
Provider Business Practice Location Address
First Line : 246 NORTHLAND DR
Second Line :
City : MEDINA
State : OH
Zip : 44256-3441
Country : US
Telephone Number : 440-260-6835
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2025
Last Update Date : 12/11/2025

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Directions to “ KYLE GOULD ” Practice Location

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