Healthcare Provider Details

I. General information

NPI: 1447176581
Provider Name (Legal Business Name): GOLDEN PSYCHOTHERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 WINNIFRED RD
BROCKTON MA
02301-4137
US

IV. Provider business mailing address

27 CENTRAL SQ # 1008
BRIDGEWATER MA
02324-2508
US

V. Phone/Fax

Practice location:
  • Phone: 508-233-3327
  • Fax:
Mailing address:
  • Phone: 508-233-3327
  • Fax: 508-463-9994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. IMARI ROCHELL MEDEIROS
Title or Position: PSYCHOTHERAPIST
Credential: LICSW
Phone: 508-233-3327