=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891659025
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHRISTA MADDEN, MSW,LCSW,LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/11/2025
-----------------------------------------------------
Last Update Date | 12/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 475 BUCKLAND RD STE D
-----------------------------------------------------
City | SOUTH WINDSOR
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06074-3738
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-748-5538
-----------------------------------------------------
Fax | 860-791-8066
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 8073
-----------------------------------------------------
City | MANCHESTER
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06040-0073
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-748-5538
-----------------------------------------------------
Fax | 860-791-8066
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LICENSED CLINICAL SOCIAL WORKER
-----------------------------------------------------
Name | MS. CHRISTA CAREN MADDEN
-----------------------------------------------------
Credential | MSW,LCSW
-----------------------------------------------------
Telephone | 860-748-5538
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------