Provider Demographics
NPI:1275804932
Name:MCFADDEN, NANCY ANN (MSW)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ANN
Last Name:MCFADDEN
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 1:510 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PAW PAW
Mailing Address - State:MI
Mailing Address - Zip Code:49079-1349
Mailing Address - Country:US
Mailing Address - Phone:269-657-6796
Mailing Address - Fax:269-657-6027
Practice Address - Street 1:510 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PAW PAW
Practice Address - State:MI
Practice Address - Zip Code:49079-1349
Practice Address - Country:US
Practice Address - Phone:269-657-6796
Practice Address - Fax:269-657-6027
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010645161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical