MEDICARE: MR. ARTHUR JOHN MADDEN M.ED., LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	12234	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2538LC	OTHER	TX	BCBS OF TEXAS

General Provider Information

NPI Number	:	1962406827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ARTHUR JOHN MADDEN M.ED., LPC

Provider Business Mailing Address
First Line	:	4245 KEMP BLVD
Second Line	:	STE 710
City	:	WICHITA FALLS
State	:	TX
Zip	:	76308-2828
Country	:	US
Telephone Number	:	940-692-9745
Fax Number	:	940-692-9722

Provider Business Practice Location Address
First Line	:	4245 KEMP BLVD
Second Line	:	STE 710
City	:	WICHITA FALLS
State	:	TX
Zip	:	76308-2828
Country	:	US
Telephone Number	:	940-692-9745
Fax Number	:	940-692-9722

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	07/08/2007

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