Provider Demographics
NPI:1700336831
Name:WINOGRAD, MADELIN MARIE (MFTI)
Entity Type:Individual
Prefix:MISS
First Name:MADELIN
Middle Name:MARIE
Last Name:WINOGRAD
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2521 HILLTOP DR. PMB 120
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-0519
Mailing Address - Country:US
Mailing Address - Phone:530-223-3019
Mailing Address - Fax:
Practice Address - Street 1:1620 MARKET ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1021
Practice Address - Country:US
Practice Address - Phone:530-225-5969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-13
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CAAMFT95479106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator