Provider Demographics
NPI:1306621131
Name:GOLDEN, ANDREA MERI (LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:MERI
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:MERI
Other - Last Name:GOLDEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:12646 GRANITE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3466
Mailing Address - Country:US
Mailing Address - Phone:240-994-8681
Mailing Address - Fax:
Practice Address - Street 1:12646 GRANITE RIDGE DR
Practice Address - Street 2:
Practice Address - City:NORTH POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20878-3466
Practice Address - Country:US
Practice Address - Phone:240-994-8681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-29
Last Update Date:2023-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD062501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical