Provider Demographics
NPI:1326442104
Name:CUSHMAN, MADELEINE (LMHC)
Entity Type:Individual
Prefix:
First Name:MADELEINE
Middle Name:
Last Name:CUSHMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:MADELEINE
Other - Middle Name:
Other - Last Name:CHAPMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13336 SE 248TH PL
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98042-6640
Mailing Address - Country:US
Mailing Address - Phone:360-800-9400
Mailing Address - Fax:360-800-9404
Practice Address - Street 1:34617 11TH PL S STE 201
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8706
Practice Address - Country:US
Practice Address - Phone:360-800-9400
Practice Address - Fax:360-800-9404
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-22
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60829118101YM0800X
WAMC60681979101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health