Individual
DARA MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1506 SEABREEZE LN, MELBOURNE, FL 32935-2030
(321) 208-3986
Mailing address
1506 SEABREEZE LN, MELBOURNE, FL 32935-2030
(321) 208-3986
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
MH25948
FL
101YP2500X
Professional Counselor
Primary
MH25948
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ADC-004887-2014
FLORIDA CERTIFICATION BOARD
FL
Enumeration date
07/21/2020
Last updated
03/19/2026
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