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General NPI Number Information
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NPI Number | 1669283909
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Entity Type | Organization
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Legal Business Name | ERIN MADDEN THERAPY, INC.
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 1101 DOVE ST STE 255
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-2819
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Country | US
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Telephone | 949-988-8858
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Fax |
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Provider Business Mailing Address
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Address Line | 17062 GREEN LN APT 79
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92649-4497
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Country | US
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Telephone | 949-988-8858
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ERIN K MADDEN
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Credential | LCSW
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Telephone | 949-988-8858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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