Provider Demographics
NPI:1114324225
Name:MADDOX, BRITNEY (LCSW)
Entity Type:Individual
Prefix:
First Name:BRITNEY
Middle Name:
Last Name:MADDOX
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 553
Mailing Address - Street 2:
Mailing Address - City:PABLO
Mailing Address - State:MT
Mailing Address - Zip Code:59855-0553
Mailing Address - Country:US
Mailing Address - Phone:406-675-0522
Mailing Address - Fax:
Practice Address - Street 1:1 EISENHOWER ST SW
Practice Address - Street 2:
Practice Address - City:RONAN
Practice Address - State:MT
Practice Address - Zip Code:59864-3302
Practice Address - Country:US
Practice Address - Phone:406-675-0522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-04
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT88741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical