Provider Demographics
NPI:1255453932
Name:POPE, MADELYNE I (MA CAGS LMFT LADC1)
Entity type:Individual
Prefix:MRS
First Name:MADELYNE
Middle Name:I
Last Name:POPE
Suffix:
Gender:F
Credentials:MA CAGS LMFT LADC1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 MARYS LN
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-2114
Mailing Address - Country:US
Mailing Address - Phone:781-545-2871
Mailing Address - Fax:
Practice Address - Street 1:13 TEMPLE ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5110
Practice Address - Country:US
Practice Address - Phone:617-471-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA626101YA0400X
MA283106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist