Provider Demographics
NPI:1043619836
Name:DUPRE, MADELEINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MADELEINE
Middle Name:
Last Name:DUPRE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 OVERLOOK AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT SIDNEY
Mailing Address - State:VA
Mailing Address - Zip Code:24467-2227
Mailing Address - Country:US
Mailing Address - Phone:540-471-6390
Mailing Address - Fax:
Practice Address - Street 1:40 OVERLOOK AVE
Practice Address - Street 2:
Practice Address - City:MOUNT SIDNEY
Practice Address - State:VA
Practice Address - Zip Code:24467-2227
Practice Address - Country:US
Practice Address - Phone:540-471-6390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-18
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0718000134101YA0400X
VA0701002399101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)