Provider Demographics
NPI:1942855655
Name:GOLDEN, HOLLY (LMHC, LMFT)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:LMHC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 HOWELL BRANCH RD STE C202
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-1172
Mailing Address - Country:US
Mailing Address - Phone:407-496-1439
Mailing Address - Fax:
Practice Address - Street 1:1555 HOWELL BRANCH RD STE C202
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-1172
Practice Address - Country:US
Practice Address - Phone:407-496-1439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH17263101YM0800X
FLMT3696106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health