Provider Demographics
NPI:1871251579
Name:ARCHER GOLDEN, PATTI (LICSW, LISW)
Entity Type:Individual
Prefix:
First Name:PATTI
Middle Name:
Last Name:ARCHER GOLDEN
Suffix:
Gender:F
Credentials:LICSW, LISW
Other - Prefix:
Other - First Name:PATTI
Other - Middle Name:JUNE
Other - Last Name:ARCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LICSW, LISW
Mailing Address - Street 1:1809 DUPONT RD STE 3
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-9704
Mailing Address - Country:US
Mailing Address - Phone:304-861-5184
Mailing Address - Fax:304-861-5187
Practice Address - Street 1:1809 DUPONT RD STE 3
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-9704
Practice Address - Country:US
Practice Address - Phone:304-861-5184
Practice Address - Fax:304-861-5187
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVDP004543101041C0700X
OHI.00096081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical