Provider Demographics
NPI:1578003471
Name:MADSEN, RHONDA JEAN (LMHC)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:JEAN
Last Name:MADSEN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5608 ZUNI RD SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-2926
Mailing Address - Country:US
Mailing Address - Phone:505-262-6597
Mailing Address - Fax:
Practice Address - Street 1:5400 GIBSON BLVD SE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-5566
Practice Address - Country:US
Practice Address - Phone:505-924-6350
Practice Address - Fax:505-768-7956
Is Sole Proprietor?:No
Enumeration Date:2017-02-27
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCCMH0199041101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional