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Individual
LACORTNEY MADDOX
Active
Individual
LACORTNEY MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, ICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
4862
HI
1041C0700X
Clinical Social Worker
Primary
5934C
AL
1041C0700X
Clinical Social Worker
91421
CA
Other
Enumeration date
02/11/2015
Last updated
05/05/2026
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