Provider Demographics
NPI:1144686619
Name:CARLISLE GOLDEN, LAUREN MELISSA (LPC, PHD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:MELISSA
Last Name:CARLISLE GOLDEN
Suffix:
Gender:F
Credentials:LPC, PHD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:MELISSA
Other - Last Name:CARLISLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, PHD
Mailing Address - Street 1:PO BOX 681473
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36068-1473
Mailing Address - Country:US
Mailing Address - Phone:334-730-3172
Mailing Address - Fax:
Practice Address - Street 1:138 S WASHINGTON ST # 105
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36067-3120
Practice Address - Country:US
Practice Address - Phone:334-730-3172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-13
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC2304A101YP2500X
AL3526101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional