Provider Demographics
NPI:1194105007
Name:RATHBONE, MADELINE ROSE (LCAS-R)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:ROSE
Last Name:RATHBONE
Suffix:
Gender:F
Credentials:LCAS-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3282
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28802-3282
Mailing Address - Country:US
Mailing Address - Phone:828-454-0560
Mailing Address - Fax:828-456-8009
Practice Address - Street 1:414 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-8026
Practice Address - Country:US
Practice Address - Phone:828-454-0560
Practice Address - Fax:828-456-8009
Is Sole Proprietor?:No
Enumeration Date:2015-06-05
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-21970101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)