Healthcare Provider Details

I. General information

NPI: 1376453498
Provider Name (Legal Business Name): MADELAINE RIKER
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

443 MAIN ST
BIDDEFORD ME
04005-2124
US

IV. Provider business mailing address

443 MAIN ST
BIDDEFORD ME
04005-2124
US

V. Phone/Fax

Practice location:
  • Phone: 207-200-6158
  • Fax:
Mailing address:
  • Phone: 207-200-6158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberXL8869
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: