Provider Demographics
NPI:1982489001
Name:GOLDAURA THERAPY, PLLC
Entity type:Organization
Organization Name:GOLDAURA THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:PRESTON
Authorized Official - Last Name:GADDY
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:919-410-8553
Mailing Address - Street 1:3503 SPENCER ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-1243
Mailing Address - Country:US
Mailing Address - Phone:919-308-0685
Mailing Address - Fax:
Practice Address - Street 1:555 S MANGUM ST STE 100
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-4689
Practice Address - Country:US
Practice Address - Phone:919-410-8553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health