Provider Demographics
NPI:1831666189
Name:MAY, MADELEINE S (MFT)
Entity Type:Individual
Prefix:
First Name:MADELEINE
Middle Name:S
Last Name:MAY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:MADDY
Other - Middle Name:
Other - Last Name:MAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:623 S AMERICAN ST REAR D
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-2300
Mailing Address - Country:US
Mailing Address - Phone:914-886-2090
Mailing Address - Fax:
Practice Address - Street 1:255 S 17TH ST STE 1106
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-6212
Practice Address - Country:US
Practice Address - Phone:914-886-2090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-25
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist