Provider Demographics
NPI:1487975801
Name:MADDEN, ANGELA (LMSW-CC)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:
Last Name:MADDEN
Suffix:
Gender:F
Credentials:LMSW-CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 STILLWATER AVENUE, SUITE 204
Mailing Address - Street 2:KIDSPEACE NATIONAL CENTERS OF NEW ENGLAND, INC.
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401
Mailing Address - Country:US
Mailing Address - Phone:207-299-1414
Mailing Address - Fax:207-947-6278
Practice Address - Street 1:444 STILLWATER AVENUE, SUITE 204
Practice Address - Street 2:KIDSPEACE NATIONAL CENTERS OF NEW ENGLAND, INC.
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401
Practice Address - Country:US
Practice Address - Phone:207-299-1414
Practice Address - Fax:207-947-6278
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC12562104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker