Provider Demographics
NPI:1205285475
Name:GOLDEN, CHRISTOPHER (QASP)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:GOLDEN
Suffix:
Gender:M
Credentials:QASP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19707 HWY 280 E
Mailing Address - Street 2:APT 309
Mailing Address - City:SMITHS STATION
Mailing Address - State:AL
Mailing Address - Zip Code:36877-4031
Mailing Address - Country:US
Mailing Address - Phone:256-566-7892
Mailing Address - Fax:
Practice Address - Street 1:10175 FORTUNE PKWY
Practice Address - Street 2:SUITE 903
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-6746
Practice Address - Country:US
Practice Address - Phone:904-538-0713
Practice Address - Fax:904-538-0714
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst