Individual
ALEX JAI MADERAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
CAMPAGNA ACADEMY, 7403 CLINE AVENUE, SCHEREVILLE, IN 46375
(219) 322-8614
Mailing address
GIBAULT CARE INC, 6401 S. US HWY 41, TERRE HAUTE, IN 47802-4749
(812) 299-1156
(812) 298-3109
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
33005858A
IN
1041C0700X
Clinical Social Worker
Primary
34006800A
IN
Other
Enumeration date
12/01/2010
Last updated
10/02/2023
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