Organization
GOLDPSYCHOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK DEEMS GOLD PH.D. (CLINICAL PSYCHOLOGIST)
(352) 502-3525
Entity
Organization
Contact information
Practice address
15151 S US HIGHWAY 441 STE 300, SUMMERFIELD, FL 34491-4482
(352) 502-3525
(352) 732-7333
Mailing address
15151 S US HIGHWAY 441 STE 300, SUMMERFIELD, FL 34491-4482
(352) 502-3525
(352) 732-7333
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831141654
UBH
—
01
—
682469
BEACON HEALTH OPTIONS
—
01
—
90100
BCBS
—
Enumeration date
09/14/2018
Last updated
09/14/2018
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