Provider Demographics
NPI:1053856187
Name:MADDOX, MORGAN ELIZABETH (LCMHC)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:ELIZABETH
Last Name:MADDOX
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 DUNAWAY DR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04073-5143
Mailing Address - Country:US
Mailing Address - Phone:207-324-7955
Mailing Address - Fax:
Practice Address - Street 1:259 OLD BAY RD
Practice Address - Street 2:
Practice Address - City:NEW DURHAM
Practice Address - State:NH
Practice Address - Zip Code:03855-2245
Practice Address - Country:US
Practice Address - Phone:802-384-4461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-28
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL4757101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health