Individual
DEBRA MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD LMHC LMFT
Contact information
Practice address
250 COMMERCIAL ST, SUITE 330, WORCESTER, MA 01608-1726
(508) 752-4665
(508) 752-0947
Mailing address
250 COMMERCIAL ST, SUITE 330, WORCESTER, MA 01608-1726
(508) 752-4665
(508) 752-0947
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4987
MA
101YM0800X
Mental Health Counselor
Primary
836
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1028720
NEIGHBORHOOD HEALTH PLAN
MA
01
—
1030720
FALLON
MA
01
—
1891782
MASS HEALTH
MA
01
—
392209
MAGELLAN
MA
01
—
7674399
AETNA
MA
01
—
LM0827
BLUE CROSS OF MA
MA
Enumeration date
04/04/2007
Last updated
02/17/2017
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