Provider Demographics
NPI:1164092334
Name:GOLDEN EDGE COUNSELING LLC
Entity Type:Organization
Organization Name:GOLDEN EDGE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:BUCKLEY
Authorized Official - Last Name:MCINTIRE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:603-498-6398
Mailing Address - Street 1:PO BOX 365
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01543-0365
Mailing Address - Country:US
Mailing Address - Phone:603-498-6398
Mailing Address - Fax:
Practice Address - Street 1:67 MILLBROOK ST STE 506
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01606-2846
Practice Address - Country:US
Practice Address - Phone:774-437-6753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty