Provider Demographics
NPI:1275155970
Name:MADOUX, NANCY (LPC AND MSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:MADOUX
Suffix:
Gender:F
Credentials:LPC AND MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 HOBBS RD APT 404
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-5124
Mailing Address - Country:US
Mailing Address - Phone:281-316-2525
Mailing Address - Fax:
Practice Address - Street 1:600 HOBBS RD APT 404
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-5124
Practice Address - Country:US
Practice Address - Phone:281-316-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-15
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19359101YP2500X
TX56434104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker