Provider Demographics
NPI:1144108713
Name:RIVER, MADELINE LEE (PSYD)
Entity type:Individual
Prefix:DR
First Name:MADELINE
Middle Name:LEE
Last Name:RIVER
Suffix:
Gender:X
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 MAPLEWOOD AVE APT 25
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4732
Mailing Address - Country:US
Mailing Address - Phone:210-912-1684
Mailing Address - Fax:
Practice Address - Street 1:3 ELM ST
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01262-7721
Practice Address - Country:US
Practice Address - Phone:413-693-2969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPSY10000949103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysisGroup - Single Specialty