Basic Information
| Provider Information | |||||||||
| NPI: | 1972518827 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GOLD | ||||||||
| FirstName: | DEBORAH | ||||||||
| MiddleName: | |||||||||
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| Credential: | LCSW, MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2363 N HILL FIELD RD STE 6 | ||||||||
| Address2: | |||||||||
| City: | LAYTON | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840416958 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8017268819 | ||||||||
| FaxNumber: | 8013361774 | ||||||||
| Practice Location | |||||||||
| Address1: | 2363 N HILL FIELD RD STE 6 | ||||||||
| Address2: | |||||||||
| City: | LAYTON | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840416958 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8017268819 | ||||||||
| FaxNumber: | 8013361774 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2006 | ||||||||
| LastUpdateDate: | 02/24/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 5421705-3501 | UT | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.