Provider Demographics
NPI:1578812376
Name:MCFADDEN, COLLIN (PHD, MA)
Entity type:Individual
Prefix:
First Name:COLLIN
Middle Name:
Last Name:MCFADDEN
Suffix:
Gender:M
Credentials:PHD, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 3RD AVE S STE 104
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-3596
Mailing Address - Country:US
Mailing Address - Phone:206-697-2539
Mailing Address - Fax:
Practice Address - Street 1:152 3RD AVE S STE 104
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-3596
Practice Address - Country:US
Practice Address - Phone:206-697-2539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPSY005662103T00000X
TX205134106H00000X
WALF60778001106H00000X
WAPY61501501103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist