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General NPI Number Information
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NPI Number | 1285299008
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Entity Type | Individual
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Provider Name | CATHERINE SHANON MADDAN LMSW-P U/S
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Gender | Female
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Dates
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Enumeration Date | 05/07/2019
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 207 N HIGHWAY 59
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City | KANSAS
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State | OK
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Zip | 74347
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Country | US
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Telephone | 918-786-4434
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Fax | 918-786-4435
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Provider Business Mailing Address
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Address Line | 282 STATE HIGHWAY 10
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City | KANSAS
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State | OK
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Zip | 74347-1640
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Country | US
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Telephone | 918-509-3528
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Fax | 918-525-0013
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 21492-P
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License Number State | OK
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