Provider Demographics
NPI:1952357907
Name:VADEN, GILES HENRY (MS)
Entity Type:Individual
Prefix:MR
First Name:GILES
Middle Name:HENRY
Last Name:VADEN
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 FIELDS POND DRIVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35756
Mailing Address - Country:US
Mailing Address - Phone:256-334-0435
Mailing Address - Fax:205-968-8373
Practice Address - Street 1:140 FIELDS POND DRIVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35756
Practice Address - Country:US
Practice Address - Phone:256-334-0435
Practice Address - Fax:205-968-8373
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246YC3302X
AL372101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No246YC3302XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationCoding Specialist, Physician Office Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL92797OtherBCBS
AL92764OtherBCBS