Provider Demographics
NPI:1780487991
Name:GOLSON, TIA M
Entity type:Individual
Prefix:
First Name:TIA
Middle Name:M
Last Name:GOLSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2483 S LINDEN RD STE 130
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-5435
Mailing Address - Country:US
Mailing Address - Phone:810-407-1715
Mailing Address - Fax:
Practice Address - Street 1:2483 S LINDEN RD STE 130
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-5435
Practice Address - Country:US
Practice Address - Phone:810-407-1715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical