Provider Demographics
NPI:1932931490
Name:MADSEN, ASPEN (LCSW)
Entity type:Individual
Prefix:
First Name:ASPEN
Middle Name:
Last Name:MADSEN
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:PO BOX 386
Mailing Address - Street 2:
Mailing Address - City:MILBANK
Mailing Address - State:SD
Mailing Address - Zip Code:57252-0386
Mailing Address - Country:US
Mailing Address - Phone:605-438-3333
Mailing Address - Fax:605-438-2110
Practice Address - Street 1:311 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MILBANK
Practice Address - State:SD
Practice Address - Zip Code:57252-1810
Practice Address - Country:US
Practice Address - Phone:605-438-3333
Practice Address - Fax:605-438-2210
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD6637104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker