Healthcare Provider Details

I. General information

NPI: 1548125669
Provider Name (Legal Business Name): GOLDEN HEALTH AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2025
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 PEERLESS ST
CRANSTON RI
02910-2561
US

IV. Provider business mailing address

555 N MAIN ST # 1361
PROVIDENCE RI
02904-5722
US

V. Phone/Fax

Practice location:
  • Phone: 401-996-1926
  • Fax:
Mailing address:
  • Phone: 401-996-1926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MADIBET GOMEZ
Title or Position: PSYCHOTHERAPIST
Credential: LMHC
Phone: 401-996-1926