Provider Demographics
NPI:1053912410
Name:GOLDEN, LAURA
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7770 NW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1902
Mailing Address - Country:US
Mailing Address - Phone:754-202-2565
Mailing Address - Fax:754-209-2738
Practice Address - Street 1:1200 S FEDERAL HWY STE 301
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-6059
Practice Address - Country:US
Practice Address - Phone:754-202-2565
Practice Address - Fax:754-209-2738
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18541101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health