MEDICARE: MEREDITH GOLDEN LCSW

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	1041C0700X	Clinical Social Worker	61448	TX

General Provider Information

NPI Number	:	1598423378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEREDITH GOLDEN LCSW

Provider Business Mailing Address
First Line	:	23902 PAPER BIRCH CT
Second Line	:
City	:	TOMBALL
State	:	TX
Zip	:	77375-1242
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	26400 KUYKENDAHL RD STE C180-278
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77375-2882
Country	:	US
Telephone Number	:	832-639-8080
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2021
Last Update Date	:	02/06/2023

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