Antionette Golden
Individual provider Active NPI Mental Health Counselor · Fairview, OR
NPI 1962860742 · NPPES record last updated Dec 13, 2016
Key facts
- NPI
- 1962860742
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 1945 NE 205TH Ave
Fairview, OR 97024-9622 - Phone
- (503) 661-8050
- Fax
- (503) 492-4651
- NPI assigned
- Feb 8, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Columbiacare Services | Past | Accepting new patients | |
| Columbiacare Services | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
1945 NE 205TH Ave
Fairview, OR 97024-9622
Mailing address
3587 Heathrow Way
Medford, OR 97504-4004
Phone (541) 858-8170
Other providers in Fairview, OR
- Melissa Fox
- Julia Rose Gertsen
- Traci L Giacchero-Pierce
- Jess Gibly
- Rean Alex Goelst
- Evan Darien Gomez Villacorta
- Celine Goodbody
- Raquel L Graham
- Montreal Granville
- Asher Grimm
All providers in Fairview, OR · Mental Health Counselor in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.