Healthcare Provider Details

I. General information

NPI: 1679482582
Provider Name (Legal Business Name): MAD CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3419 KILAUEA AVE APT A
HONOLULU HI
96816-7170
US

IV. Provider business mailing address

4539 N 22ND ST # 7285
PHOENIX AZ
85016-4639
US

V. Phone/Fax

Practice location:
  • Phone: 928-471-5998
  • Fax:
Mailing address:
  • Phone: 928-471-5998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARIE DELABARRERA
Title or Position: OWNER
Credential: LMHC, LPC, NCC
Phone: 928-471-5998