Provider Demographics
NPI:1154661874
Name:GOLDEN, LEONIA STARDEHLIA (LPC)
Entity Type:Individual
Prefix:
First Name:LEONIA
Middle Name:STARDEHLIA
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 SW JOHNSON AVE
Mailing Address - Street 2:STE. C
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-5833
Mailing Address - Country:US
Mailing Address - Phone:817-447-3001
Mailing Address - Fax:
Practice Address - Street 1:621 SW JOHNSON AVE
Practice Address - Street 2:STE. C
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-5833
Practice Address - Country:US
Practice Address - Phone:817-447-3001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65203101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor