Provider Demographics
NPI:1427586718
Name:KARA B GOLDEN LLC
Entity Type:Organization
Organization Name:KARA B GOLDEN LLC
Other - Org Name:KARA B GOLDEN, LCSW COUNSELING & CONSULTING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LCSW/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KARA
Authorized Official - Middle Name:B
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:570-760-1227
Mailing Address - Street 1:130 BRIDGE ST STE 5
Mailing Address - Street 2:
Mailing Address - City:TUNKHANNOCK
Mailing Address - State:PA
Mailing Address - Zip Code:18657-1354
Mailing Address - Country:US
Mailing Address - Phone:570-760-1227
Mailing Address - Fax:570-996-6114
Practice Address - Street 1:130 BRIDGE ST STE 5
Practice Address - Street 2:
Practice Address - City:TUNKHANNOCK
Practice Address - State:PA
Practice Address - Zip Code:18657-1354
Practice Address - Country:US
Practice Address - Phone:570-760-1227
Practice Address - Fax:570-996-6114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW018153251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103015387Medicaid