Healthcare Provider Details

I. General information

NPI: 1891659470
Provider Name (Legal Business Name): GOLDEN GROVE COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 N TEMPLE BLVD
TEMPLE PA
19560-1736
US

IV. Provider business mailing address

610 N TEMPLE BLVD
TEMPLE PA
19560-1736
US

V. Phone/Fax

Practice location:
  • Phone: 570-417-2323
  • Fax:
Mailing address:
  • Phone: 570-417-2323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KELLY SUSANNE MCCAUGHEY
Title or Position: OWNER/FOUNDER
Credential: LCSW
Phone: 570-417-2323