Provider Demographics
NPI:1174614903
Name:MADDEN, HARRIET BAER (LMFT)
Entity type:Individual
Prefix:
First Name:HARRIET
Middle Name:BAER
Last Name:MADDEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:HARRIET
Other - Middle Name:BAER
Other - Last Name:MADDEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:250 DEWEY AVE
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-3009
Mailing Address - Country:US
Mailing Address - Phone:864-585-0366
Mailing Address - Fax:864-585-9208
Practice Address - Street 1:250 DEWEY AVE
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3009
Practice Address - Country:US
Practice Address - Phone:864-585-0366
Practice Address - Fax:864-585-9208
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2493106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC121328Medicaid
SC3335Medicare ID - Type Unspecified