Provider Demographics
NPI:1952706384
Name:GOLDENWOOD SERVICES, LLC
Entity Type:Organization
Organization Name:GOLDENWOOD SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:215-479-6439
Mailing Address - Street 1:2865 S EAGLE RD
Mailing Address - Street 2:SUITE 335
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1546
Mailing Address - Country:US
Mailing Address - Phone:215-479-6439
Mailing Address - Fax:
Practice Address - Street 1:2865 S EAGLE RD
Practice Address - Street 2:SUITE 335
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1546
Practice Address - Country:US
Practice Address - Phone:215-479-6439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005263L103TC0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty