Provider Demographics
NPI:1316698988
Name:MADDEN, COURTNEY JEAN (LCSW)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:JEAN
Last Name:MADDEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 ORCHARD AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08083-2542
Mailing Address - Country:US
Mailing Address - Phone:609-605-8066
Mailing Address - Fax:
Practice Address - Street 1:234 ORCHARD AVE
Practice Address - Street 2:
Practice Address - City:SOMERDALE
Practice Address - State:NJ
Practice Address - Zip Code:08083-2542
Practice Address - Country:US
Practice Address - Phone:609-605-8066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC060359001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical