MEDICARE: MADDEN COUNSELING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	12234	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568604189
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MADDEN COUNSELING

Provider Business Mailing Address
First Line	:	4245 KEMP BLVD STE 710
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76308-2828
Country	:	US
Telephone Number	:	940-692-9745
Fax Number	:	940-692-9722

Provider Business Practice Location Address
First Line	:	4245 KEMP BLVD STE 710
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76308-2828
Country	:	US
Telephone Number	:	940-692-9745
Fax Number	:	940-692-9722

Authorized Official
Title or Position	:	OWNER/COUNSELOR
Name	:	MR. ARTHUR J MADDEN
Credential	:	M.ED., LPC
Telephone Number	:	940-692-9745

Provider Enumeration Date	:	03/27/2009
Last Update Date	:	03/27/2009

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