MEDICARE: GOLDEN STEPS

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	101YM0800X	Mental Health Counselor
2	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1750940896
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN STEPS

Provider Business Mailing Address
First Line	:	2600 N MAIN ST # 200
Second Line	:
City	:	NORTH LOGAN
State	:	UT
Zip	:	84341-5740
Country	:	US
Telephone Number	:	435-774-6533
Fax Number	:

Provider Business Practice Location Address
First Line	:	2600 N MAIN ST # 200
Second Line	:
City	:	NORTH LOGAN
State	:	UT
Zip	:	84341-5740
Country	:	US
Telephone Number	:	435-774-6533
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	COLDEN D GLENN
Credential	:
Telephone Number	:	435-774-6533

Provider Enumeration Date	:	06/12/2019
Last Update Date	:	11/18/2019

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Directions to “GOLDEN STEPS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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