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General NPI Number Information
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NPI Number | 1447176581
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Entity Type | Organization
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Legal Business Name | GOLDEN PSYCHOTHERAPY, PLLC
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Dates
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Enumeration Date | 06/24/2026
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Last Update Date | 06/24/2026
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Provider Practice Location Address
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Address Line | 115 WINNIFRED RD
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City | BROCKTON
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State | MA
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Zip | 02301-4137
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Country | US
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Telephone | 508-233-3327
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Fax |
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Provider Business Mailing Address
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Address Line | 27 CENTRAL SQ # 1008
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City | BRIDGEWATER
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State | MA
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Zip | 02324-2508
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Country | US
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Telephone | 508-233-3327
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Fax | 508-463-9994
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MS. IMARI ROCHELL MEDEIROS
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Credential | LICSW
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Telephone | 508-233-3327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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