| Doctor Name: | MRS. ELLEN GOLD |
| NPI Number: | 1194078568 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MPS, BCDMT, LPC |
| License Number: | 37PC00234600 |
| Business Practice Address: | 11726 Lariat Lanee Oakton, VA - 22124 |
| Business Phone Number: | 7038608188 |
| Business Fax Number: | |
| Mailing Address: | 11726 Lariat Ln, OAKTON |
| State: | VA |
| Postal Code: | 221242323 |
| Phone Number: | 7038608188 |
| Fax Number: | |
| NPI Enumeration Date: | 10/22/2012 |
| NPI Last Update Date: | 10/22/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 37PC00234600 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |