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General NPI Number Information
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NPI Number | 1083908107
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Entity Type | Individual
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Provider Name | JANICE L MADDOX LMFT
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Gender | Female
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Dates
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Enumeration Date | 06/06/2011
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Last Update Date | 02/08/2022
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Provider Practice Location Address
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Address Line | 305 STEWART ST
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City | RENO
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State | NV
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Zip | 89502-1606
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Country | US
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Telephone | 775-384-2442
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Fax | 775-473-7164
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Provider Business Mailing Address
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Address Line | 240 S HUMAHUACA ST
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City | PAHRUMP
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State | NV
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Zip | 89048-2199
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Country | US
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Telephone | 775-751-7406
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Fax | 775-751-7409
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LADC01558-L
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0913
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License Number State | NV
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