Provider Demographics
NPI:1902519051
Name:JOALLA H GOLD, LICENSED CLINICAL SOCIAL WORKER, INC
Entity Type:Organization
Organization Name:JOALLA H GOLD, LICENSED CLINICAL SOCIAL WORKER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOALLA
Authorized Official - Middle Name:H
Authorized Official - Last Name:GOLD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:818-645-5195
Mailing Address - Street 1:5239 TENDILLA AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1830
Mailing Address - Country:US
Mailing Address - Phone:818-645-5195
Mailing Address - Fax:818-888-7089
Practice Address - Street 1:10649 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:TOLUCA LAKE
Practice Address - State:CA
Practice Address - Zip Code:91602-2341
Practice Address - Country:US
Practice Address - Phone:818-789-5122
Practice Address - Fax:818-888-7089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty