Crockett, Madeleine
Crockett, Madeleine is an sole proprietor health care provider with primary practice located at 120 Providence Rd Ste 102, Chapel Hill NC 27514-2273. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Crockett, Madeleine can be contacted via phone (919) 401-3680.Contact Information
Primary practice address
120 Providence Rd Ste 102
Chapel Hill NC 27514-2273
Phone: (919) 401-3680
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2129 | North Carolina |
Profile Details
| NPI number | 1447254719 |
|---|---|
| LBN Legal business name | Crockett, Madeleine |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 2nd, 2005 |
| Last updated | Aug 14th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447254719 | NPPES |
| North Carolina | Other | 03986 | BLUE CROSS BLUE SHIELD |
| North Carolina | MEDICAID | 6000386 | BLUE CROSS BLUE SHIELD |
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