Individual
DR. MADELEINE CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
120 PROVIDENCE RD, STE 102, CHAPEL HILL, NC 27514-2273
(919) 401-3680
Mailing address
120 PROVIDENCE RD, STE 102, CHAPEL HILL, NC 27514-2273
(919) 401-3680
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2129
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03986
BLUE CROSS BLUE SHIELD
NC
05
—
6000386
—
NC
Enumeration date
06/02/2005
Last updated
08/14/2007
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