Provider Demographics
NPI:1013059849
Name:GOLDEN, JOAN E (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:E
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:JOAN
Other - Middle Name:E
Other - Last Name:GOLDEN-ALEXIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:55 CAMBRIDGE PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-1907
Mailing Address - Country:US
Mailing Address - Phone:212-982-1191
Mailing Address - Fax:
Practice Address - Street 1:10 W 9TH ST
Practice Address - Street 2:GARDEN FRONT
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8983
Practice Address - Country:US
Practice Address - Phone:212-982-1191
Practice Address - Fax:646-613-9571
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4999-1103TC0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV29371Medicare ID - Type Unspecified