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General NPI Number Information
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NPI Number | 1801381942
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Entity Type | Organization
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Legal Business Name | GOLDEN DAYS COUNSELING LLC
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Dates
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Enumeration Date | 06/29/2018
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Last Update Date | 05/12/2023
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Provider Practice Location Address
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Address Line | 1009 FREDERICK RD STE 1
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City | CATONSVILLE
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State | MD
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Zip | 21228-5055
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Country | US
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Telephone | 410-870-5360
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Fax | 443-687-8714
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Provider Business Mailing Address
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Address Line | 2600 TANEY RD
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City | BALTIMORE
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State | MD
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Zip | 21209-3916
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Country | US
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Telephone | 410-870-5360
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Fax | 443-687-8714
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | ELISA SUE FULD
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Credential | LCSW
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Telephone | 410-870-5360
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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 | 20269
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License Number State | MD
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