Provider Demographics
NPI:1053121673
Name:GOLDEN, MACKENZIE CATHERINE (LISW-S)
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:CATHERINE
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5775 N MEADOWS DR STE A
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-7300
Mailing Address - Country:US
Mailing Address - Phone:614-325-0509
Mailing Address - Fax:
Practice Address - Street 1:5775 N MEADOWS DR STE A
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-7300
Practice Address - Country:US
Practice Address - Phone:614-325-0509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.2304492-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical