Provider Demographics
NPI:1700801412
Name:MCFADDEN, DEBORAH L (LCSW)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:L
Last Name:MCFADDEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 212
Mailing Address - Street 2:
Mailing Address - City:CABLE
Mailing Address - State:WI
Mailing Address - Zip Code:54821-0212
Mailing Address - Country:US
Mailing Address - Phone:630-333-3203
Mailing Address - Fax:315-217-2428
Practice Address - Street 1:41810 VALHALLA TOWHNHOUSE RD UNIT 11
Practice Address - Street 2:
Practice Address - City:CABLE
Practice Address - State:WI
Practice Address - Zip Code:54821-5401
Practice Address - Country:US
Practice Address - Phone:630-333-3202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490073971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
702480Medicare ID - Type Unspecified