Provider Demographics
NPI:1285075978
Name:GOLDEN, CLAIRE (PHD)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 27TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11232-1601
Mailing Address - Country:US
Mailing Address - Phone:347-446-9307
Mailing Address - Fax:646-317-1152
Practice Address - Street 1:635 W 165TH ST
Practice Address - Street 2:ROOM 637
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3724
Practice Address - Country:US
Practice Address - Phone:646-317-0436
Practice Address - Fax:646-317-1152
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-10
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TS0200X
NY021019103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY748443131OtherSCHOOL PSYCHOLOGY CERTIFICATION