Individual
STEPHANIE GOULD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21 OLD ROUTE 6, CARMEL, NY 10512-2107
(845) 225-5202
(845) 225-0700
Mailing address
79 GLENRIDGE RD, GLENVILLE, NY 12302-4523
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
30128
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01420795
—
NY
Enumeration date
02/16/2023
Last updated
03/06/2025
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