Provider Demographics
NPI:1285349183
Name:MADDEN, JADYN ROSE (LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:JADYN
Middle Name:ROSE
Last Name:MADDEN
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 POLAR LN STE 501
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-3073
Mailing Address - Country:US
Mailing Address - Phone:512-400-4321
Mailing Address - Fax:
Practice Address - Street 1:3000 POLAR LN STE 501
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-3073
Practice Address - Country:US
Practice Address - Phone:512-400-4321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87964101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health