Provider Demographics
NPI:1447093505
Name:MADISON COUNTY PATH
Entity type:Organization
Organization Name:MADISON COUNTY PATH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINCIAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMRA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIGDON
Authorized Official - Suffix:
Authorized Official - Credentials:LSW/LAC
Authorized Official - Phone:765-810-7258
Mailing Address - Street 1:601 MERIDIAN ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46016-1518
Mailing Address - Country:US
Mailing Address - Phone:765-810-7258
Mailing Address - Fax:
Practice Address - Street 1:601 MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46016-1518
Practice Address - Country:US
Practice Address - Phone:765-810-7258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MADISON COUNTY TURNING POINT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty