Provider Demographics
NPI:1942569207
Name:MARKEN, MADELEINE I (LICSW)
Entity Type:Individual
Prefix:
First Name:MADELEINE
Middle Name:I
Last Name:MARKEN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 PAGE STREET
Mailing Address - Street 2:SOUTHCOAST HEALTH , SOCIAL SERVICES
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-3464
Mailing Address - Country:US
Mailing Address - Phone:508-961-5500
Mailing Address - Fax:508-961-5501
Practice Address - Street 1:101 PAGE ST
Practice Address - Street 2:SOUTHCOAST HOSPITAL GROUPS, INC
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-3464
Practice Address - Country:US
Practice Address - Phone:508-961-5500
Practice Address - Fax:508-961-5501
Is Sole Proprietor?:No
Enumeration Date:2012-05-08
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA106417104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker