Provider Demographics
NPI:1427141811
Name:GOLDEN, BERNADETTE (LMFT)
Entity type:Individual
Prefix:MS
First Name:BERNADETTE
Middle Name:
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 BAYONET ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320
Mailing Address - Country:US
Mailing Address - Phone:860-443-4163
Mailing Address - Fax:860-437-3926
Practice Address - Street 1:400 BAYONET ST
Practice Address - Street 2:SUITE 202
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320
Practice Address - Country:US
Practice Address - Phone:860-443-4163
Practice Address - Fax:860-437-3926
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-30
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT000416106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist