Provider Demographics
NPI:1750670790
Name:MADRIGALE, DIANE ELIZABETH (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:ELIZABETH
Last Name:MADRIGALE
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 W. AMAZON DR. #3
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-3874
Mailing Address - Country:US
Mailing Address - Phone:541-687-6629
Mailing Address - Fax:
Practice Address - Street 1:2149 CENTENNIAL PLZ STE 4
Practice Address - Street 2:EMERGENCE
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2456
Practice Address - Country:US
Practice Address - Phone:541-741-7107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health