Provider Demographics
NPI:1396964771
Name:MADER, JAMES (LMHC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:MADER
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6236 APACHE PLUME RD NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-5166
Mailing Address - Country:US
Mailing Address - Phone:505-220-7782
Mailing Address - Fax:
Practice Address - Street 1:6236 APACHE PLUME RD NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144-5166
Practice Address - Country:US
Practice Address - Phone:505-220-7782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2819101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health