Healthcare Provider Details

I. General information

NPI: 1255453932
Provider Name (Legal Business Name): MADELYNE I POPE MA CAGS LMFT LADC1
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 TEMPLE ST
QUINCY MA
02169-5110
US

IV. Provider business mailing address

19 MARYS LN
SCITUATE MA
02066-2114
US

V. Phone/Fax

Practice location:
  • Phone: 617-471-8400
  • Fax:
Mailing address:
  • Phone: 781-545-2871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number626
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number283
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: