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General NPI Number Information
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NPI Number | 1952541294
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Entity Type | Individual
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Provider Name | REBECCA LYNN MADEEN LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/26/2009
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Last Update Date | 10/28/2022
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Provider Practice Location Address
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Address Line | 2470 SAINT ROSE PKWY STE 302
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City | HENDERSON
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State | NV
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Zip | 89074-7776
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Country | US
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Telephone | 701-226-6569
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Fax |
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Provider Business Mailing Address
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Address Line | 2470 SAINT ROSE PKWY STE 302
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City | HENDERSON
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State | NV
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Zip | 89074-7776
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Country | US
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Telephone | 701-226-6569
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2989
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License Number State | ND
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