Provider Demographics
NPI:1427736834
Name:CILANO, MADISON MURIEL
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:MURIEL
Last Name:CILANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 FISHTOWN RD
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:ME
Mailing Address - Zip Code:04862-7408
Mailing Address - Country:US
Mailing Address - Phone:207-409-0093
Mailing Address - Fax:
Practice Address - Street 1:260 FISHTOWN RD
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:ME
Practice Address - Zip Code:04862-7408
Practice Address - Country:US
Practice Address - Phone:207-400-0290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-06
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL7153101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty