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General NPI Number Information
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NPI Number | 1750940896
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Entity Type | Organization
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Legal Business Name | GOLDEN STEPS
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Dates
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Enumeration Date | 06/12/2019
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Last Update Date | 11/18/2019
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Provider Practice Location Address
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Address Line | 2600 N MAIN ST # 200
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City | NORTH LOGAN
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State | UT
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Zip | 84341-5740
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Country | US
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Telephone | 435-774-6533
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Fax |
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Provider Business Mailing Address
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Address Line | 2600 N MAIN ST # 200
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City | NORTH LOGAN
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State | UT
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Zip | 84341-5740
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Country | US
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Telephone | 435-774-6533
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | COLDEN D GLENN
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Credential |
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Telephone | 435-774-6533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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