MEDICARE: GOLD ORANGE THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1457238289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLD ORANGE THERAPY LLC

Provider Business Mailing Address
First Line	:	7304 HAMPTON BLVD APT A
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23505-2924
Country	:	US
Telephone Number	:	757-806-0224
Fax Number	:

Provider Business Practice Location Address
First Line	:	7304 HAMPTON BLVD APT A
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23505-2924
Country	:	US
Telephone Number	:	757-780-7900
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTINA D. PALMER
Credential	:
Telephone Number	:	757-806-0224

Provider Enumeration Date	:	08/21/2025
Last Update Date	:	08/21/2025

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Directions to “GOLD ORANGE THERAPY LLC ” Practice Location

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