Provider Demographics
NPI:1144112145
Name:PUCHERIL, MADELINE MCJUNKIN (LMSW)
Entity type:Individual
Prefix:MRS
First Name:MADELINE
Middle Name:MCJUNKIN
Last Name:PUCHERIL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 W 43RD ST APT 12F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-4311
Mailing Address - Country:US
Mailing Address - Phone:707-365-5723
Mailing Address - Fax:
Practice Address - Street 1:767 BROADWAY
Practice Address - Street 2:PO BOX 1327
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:813-644-9912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY127721104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker