Healthcare Provider Details
I. General information
NPI: 1033519350
Provider Name (Legal Business Name): LAUREN A GOLDEN PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/25/2014
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13815 N 50TH ST
SCOTTSDALE AZ
85254-2863
US
IV. Provider business mailing address
13815 N 50TH ST
SCOTTSDALE AZ
85254-2863
US
V. Phone/Fax
- Phone: 602-881-2313
- Fax:
- Phone: 602-881-2313
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PSY-005696 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | 2018030706 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: