Provider Demographics
NPI:1851362198
Name:DOWDY, MADELINE GONZALES (LCSW)
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:GONZALES
Last Name:DOWDY
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 1:4131 SPICEWOOD SPRINGS RD
Mailing Address - Street 2:STE F 1
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8659
Mailing Address - Country:US
Mailing Address - Phone:512-342-2223
Mailing Address - Fax:512-342-7878
Practice Address - Street 1:4131 SPICEWOOD SPRINGS RD
Practice Address - Street 2:STE F 1
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8659
Practice Address - Country:US
Practice Address - Phone:512-342-2223
Practice Address - Fax:512-342-7878
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS03636104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX116509403Medicaid
TX116509403Medicaid