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NPI Code Detail

MEDICARE: KATHLEEN MARIE MADORE LCSW

MEDICARE: KATHLEEN MARIE MADORE LCSW
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
11041C0700XClinical Social WorkerL6421OR
2101Y00000XCounselor

General Provider Information

NPI Number : 1841442795
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN MARIE MADORE LCSW
Provider Business Mailing Address
First Line : 3729 KLINDT DR
Second Line :
City : THE DALLES
State : OR
Zip : 97058-3566
Country : US
Telephone Number : 541-720-8258
Fax Number :
Provider Business Practice Location Address
First Line : 3729 KLINDT DR
Second Line :
City : THE DALLES
State : OR
Zip : 97058-3566
Country : US
Telephone Number : 541-720-8258
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2008
Last Update Date : 11/14/2023

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Directions to “ KATHLEEN MARIE MADORE LCSW” Practice Location

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