Doctor Name: | STEPHANIE PAIGE MADDEX |
NPI Number: | 1265657514 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 34005317A |
Business Practice Address: | 215 W Indiana Ave Chesterton, IN - 463042457 |
Business Phone Number: | 2199210705 |
Business Fax Number: | 2199210557 |
Mailing Address: | 215 W Indiana Ave, CHESTERTON |
State: | IN |
Postal Code: | 463042457 |
Phone Number: | 2199210705 |
Fax Number: | 2199210557 |
NPI Enumeration Date: | 04/13/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 34005317A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |