Provider Demographics
NPI:1982942165
Name:CRAIN-HEWETT, MADELINE (MED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:MADELINE
Middle Name:
Last Name:CRAIN-HEWETT
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 TAYLOR DR
Mailing Address - Street 2:
Mailing Address - City:HORSESHOE BAY
Mailing Address - State:TX
Mailing Address - Zip Code:78657-7062
Mailing Address - Country:US
Mailing Address - Phone:806-773-6373
Mailing Address - Fax:
Practice Address - Street 1:505 TAYLOR DR
Practice Address - Street 2:
Practice Address - City:HORSESHOE BAY
Practice Address - State:TX
Practice Address - Zip Code:78657-7062
Practice Address - Country:US
Practice Address - Phone:806-773-6373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-23
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67836101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional