Provider Demographics
NPI:1740677673
Name:GOLDEN POND COUNSELING
Entity type:Organization
Organization Name:GOLDEN POND COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSE PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:936-676-7656
Mailing Address - Street 1:567 JOSSERAND RD
Mailing Address - Street 2:PO BOX 1264
Mailing Address - City:GROVETON
Mailing Address - State:TX
Mailing Address - Zip Code:75845-4793
Mailing Address - Country:US
Mailing Address - Phone:936-676-7656
Mailing Address - Fax:936-642-2129
Practice Address - Street 1:567 JOSSERAND RD
Practice Address - Street 2:
Practice Address - City:GROVETON
Practice Address - State:TX
Practice Address - Zip Code:75845-4793
Practice Address - Country:US
Practice Address - Phone:936-676-7656
Practice Address - Fax:936-642-2095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70161101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty