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Individual

DOLORES MADIOU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW-C

Contact information

Practice address
10451 TWIN RIVERS RD, COLUMBIA, MD 21044-2388
(410) 997-3557
(410) 964-1791
Mailing address
4623 FALLS RD, BALTIMORE, MD 21209-4914
(410) 366-1980
(410) 366-8530

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
01262
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11249314
CAQH
MD
01
226092
KAISER
MD
01
239330-000
MAGELLAN HEALTHCARE
MD
01
280361
MAMSI
MD
01
399170
TRICARE
MD
01
417290
BCBS
MD
05
492610200
MD
01
7618409
AETNA BEHAVIORAL HEALTH
MD
01
PVP134855
APS HEALTHCARE
MD
01
T541 0025
BCBS-DC
MD
Enumeration date
07/14/2006
Last updated
01/22/2009
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