Provider Demographics
NPI:1730906256
Name:GOLDEN, BRIAN (LADAC)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:GOLDEN
Suffix:
Gender:M
Credentials:LADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-0030
Mailing Address - Country:US
Mailing Address - Phone:731-642-0521
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 30
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-0030
Practice Address - Country:US
Practice Address - Phone:731-642-0521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)