Provider Demographics
NPI:1104940444
Name:GOLDEN, THOMAS R (LCSW)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:R
Last Name:GOLDEN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2733 JOHN MILLS RD
Mailing Address - Street 2:
Mailing Address - City:ADAMSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21710-8936
Mailing Address - Country:US
Mailing Address - Phone:301-670-1027
Mailing Address - Fax:301-810-5237
Practice Address - Street 1:849 QUINCE ORCHARD BLVD
Practice Address - Street 2:STE I
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-1684
Practice Address - Country:US
Practice Address - Phone:301-670-1027
Practice Address - Fax:301-810-5237
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD32071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical