Provider Demographics
NPI:1679978308
Name:GOLDEN, JEFFREY CHARLES (LMSW)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:CHARLES
Last Name:GOLDEN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 PEMBROKE CT
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-6404
Mailing Address - Country:US
Mailing Address - Phone:716-271-1445
Mailing Address - Fax:716-271-1445
Practice Address - Street 1:1001 11TH ST
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301-1201
Practice Address - Country:US
Practice Address - Phone:716-278-8110
Practice Address - Fax:716-278-8111
Is Sole Proprietor?:No
Enumeration Date:2014-10-23
Last Update Date:2023-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060141-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker