Provider Demographics
NPI:1457967887
Name:HARDEN-MADDOX, RACHEL DIANE (LCPC, CADC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:DIANE
Last Name:HARDEN-MADDOX
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20015 S LAGRANGE RD # 1269
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-3104
Mailing Address - Country:US
Mailing Address - Phone:708-953-9355
Mailing Address - Fax:
Practice Address - Street 1:2946 CARMEL DR
Practice Address - Street 2:
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-2284
Practice Address - Country:US
Practice Address - Phone:708-953-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180014989101YM0800X
IL178016214101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health