Provider Demographics
NPI:1861891806
Name:GOLD, LAURAMAERY (LMFT, MA-MFT)
Entity type:Individual
Prefix:
First Name:LAURAMAERY
Middle Name:
Last Name:GOLD
Suffix:
Gender:F
Credentials:LMFT, MA-MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4509 TALBOT RD S
Mailing Address - Street 2:SUITE 105
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-6294
Mailing Address - Country:US
Mailing Address - Phone:425-429-2230
Mailing Address - Fax:
Practice Address - Street 1:4509 TALBOT RD S
Practice Address - Street 2:SUITE 105
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-6294
Practice Address - Country:US
Practice Address - Phone:425-429-2230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-15
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACL60506066101Y00000X, 101YM0800X, 101YP1600X, 101YP2500X
WALF60979213106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional