Provider Demographics
NPI:1316161904
Name:MADISON, KACI CAMERRON (MA, CAADC, CAC-AD)
Entity type:Individual
Prefix:MS
First Name:KACI
Middle Name:CAMERRON
Last Name:MADISON
Suffix:
Gender:F
Credentials:MA, CAADC, CAC-AD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:30000 CORDREY ROAD
Mailing Address - Street 2:
Mailing Address - City:MILLSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19966
Mailing Address - Country:US
Mailing Address - Phone:302-227-1320
Mailing Address - Fax:302-227-1327
Practice Address - Street 1:20576 COASTAL HIGHWAY
Practice Address - Street 2:
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971
Practice Address - Country:US
Practice Address - Phone:302-227-1320
Practice Address - Fax:302-227-1327
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)