Provider Demographics
NPI:1073696852
Name:GOLDEN, CHARLES JOSH (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:JOSH
Last Name:GOLDEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
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Mailing Address - Street 1:2862 NE 35TH CT
Mailing Address - Street 2:
Mailing Address - City:LIGHTHOUSE POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33064-8574
Mailing Address - Country:US
Mailing Address - Phone:954-262-5715
Mailing Address - Fax:954-283-8655
Practice Address - Street 1:3301 COLLEGE AVENUE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33314
Practice Address - Country:US
Practice Address - Phone:954-262-5715
Practice Address - Fax:954-283-8655
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPY5226103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist