Provider Demographics
NPI:1841927233
Name:MCCLAIN, MADISON T
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:T
Last Name:MCCLAIN
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 1:99 WEDGEFIELD PL
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-2227
Mailing Address - Country:US
Mailing Address - Phone:908-644-2415
Mailing Address - Fax:
Practice Address - Street 1:99 WEDGEFIELD PL
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2227
Practice Address - Country:US
Practice Address - Phone:908-644-2415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician