Provider Demographics
NPI:1821586322
Name:MAI, MADELYN HOANGDIEM (MSW)
Entity Type:Individual
Prefix:
First Name:MADELYN HOANGDIEM
Middle Name:
Last Name:MAI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:HOANG
Other - Middle Name:T
Other - Last Name:MAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8246 GRIZZLY PEAK DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-5327
Mailing Address - Country:US
Mailing Address - Phone:816-682-2378
Mailing Address - Fax:
Practice Address - Street 1:6600 W CHARLESTON BLVD STE 140
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-1067
Practice Address - Country:US
Practice Address - Phone:702-437-4673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health