Provider Demographics
NPI:1528227030
Name:MADIOU, MICHELE (LCSW)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:MADIOU
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 1:1123 LOWER FERRY RD
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-1801
Mailing Address - Country:US
Mailing Address - Phone:609-577-3474
Mailing Address - Fax:
Practice Address - Street 1:1123 LOWER FERRY RD
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08618-1801
Practice Address - Country:US
Practice Address - Phone:609-577-3474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC 148621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical