Stacy Golden

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

STACY GOLDEN

Doing business as

Boundless Expression Therapy & Diag

Practice address

1550 N Verdugo Rd Apt 37
Glendale, CA 91208-2834

Phone

(805) 216-5604

NPI assigned

Nov 22, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Stacy Golden, MS, CCC-SLP

Title

Owner/Provider

Phone

(805) 216-5604

Specialties & licenses 2

Addresses

Other names 1

• Boundless Expression Therapy & Diag Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1574380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574380800000",
    "number": "1902442130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 N VERDUGO RD APT 37",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912082834",
            "telephone_number": "805-216-5604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 N VERDUGO RD APT 37",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912082834",
            "telephone_number": "805-216-5604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACY GOLDEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-22",
        "last_updated": "2019-11-22",
        "status": "A",
        "authorized_official_last_name": "GOLDEN",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "805-216-5604",
        "authorized_official_credential": "MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boundless Expression Therapy & Diag",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Early Intervention Provider Agency in Glendale, CA
• Providers in Glendale, CA by specialty
• Early Intervention Provider Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.