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General NPI Number Information
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NPI Number | 1891659470
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Entity Type | Organization
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Legal Business Name | GOLDEN GROVE COUNSELING, LLC
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 610 N TEMPLE BLVD
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City | TEMPLE
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State | PA
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Zip | 19560-1736
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Country | US
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Telephone | 570-417-2323
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Fax |
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Provider Business Mailing Address
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Address Line | 610 N TEMPLE BLVD
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City | TEMPLE
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State | PA
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Zip | 19560-1736
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Country | US
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Telephone | 570-417-2323
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Fax |
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Authorized Official
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Title or Position | OWNER/FOUNDER
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Name | KELLY SUSANNE MCCAUGHEY
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Credential | LCSW
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Telephone | 570-417-2323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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