Provider Demographics
NPI:1992478192
Name:WIEMAN, MADELINE BROPHY (LCSW)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:BROPHY
Last Name:WIEMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MADELINE
Other - Middle Name:
Other - Last Name:BROPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 ALSTON BLVD
Mailing Address - Street 2:STE C PMB 1003
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-7011
Mailing Address - Country:US
Mailing Address - Phone:910-212-6757
Mailing Address - Fax:
Practice Address - Street 1:201 ALSTON BLVD
Practice Address - Street 2:STE C PMB 1003
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443-7011
Practice Address - Country:US
Practice Address - Phone:910-212-6757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical