Provider Demographics
NPI:1417402629
Name:MOREE, MADELINE (LCSW)
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:
Last Name:MOREE
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 1:4821 BROOKRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-7877
Mailing Address - Country:US
Mailing Address - Phone:319-321-2840
Mailing Address - Fax:
Practice Address - Street 1:5949 SHERRY LN # 752
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-6532
Practice Address - Country:US
Practice Address - Phone:214-890-9880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-17
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA083868104100000X
TX696551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker