Provider Demographics
NPI:1508370420
Name:GOLDEN, MEGAN N (LSW, CDCA)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:N
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:LSW, CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1454 E WHEELING ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-3357
Mailing Address - Country:US
Mailing Address - Phone:740-503-5724
Mailing Address - Fax:
Practice Address - Street 1:1434 COLLINS RD NW
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8815
Practice Address - Country:US
Practice Address - Phone:740-243-5016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-30
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS1701448101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0284815Medicaid