Healthcare Provider Details

I. General information

NPI: 1992217251
Provider Name (Legal Business Name): SAMANTHA L GOLDEN LMFT, CMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2017
Last Update Date: 07/16/2023
Certification Date: 07/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5814 S 900 E
MURRAY UT
84121-1644
US

IV. Provider business mailing address

5814 S 900 E
MURRAY UT
84121-1644
US

V. Phone/Fax

Practice location:
  • Phone: 385-800-3272
  • Fax: 385-800-3260
Mailing address:
  • Phone: 385-800-3272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11862129-6004
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2001656
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number268693
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberM.1700051
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberF.2000150
License Number StateOH
# 6
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number11862129-3902
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: