Provider Demographics
NPI:1124357538
Name:VUCOVICH, MADELINE KATE (MSW)
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:KATE
Last Name:VUCOVICH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 HILYARD ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-8122
Mailing Address - Country:US
Mailing Address - Phone:541-682-7583
Mailing Address - Fax:541-687-6214
Practice Address - Street 1:1200 HILYARD ST
Practice Address - Street 2:SUITE 200
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-8122
Practice Address - Country:US
Practice Address - Phone:541-682-7583
Practice Address - Fax:541-687-6214
Is Sole Proprietor?:No
Enumeration Date:2009-12-14
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL47681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical