JEANETTA RENA MADDOX M.S.W. NPI 1104098987

NPI Information

  • NPI: 1104098987
  • Provider Name: JEANETTA RENA MADDOX, M.S.W.
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • Address: 1307 E ELM ST
    ATHENS, AL
    ZIP 35611
  • Phone: (256) 232-3661

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NPI Details

Jeanetta Rena Maddox, M.S.W. is a mental health counselor in Athens, AL. Jeanetta Rena Maddox, M.S.W. NPI is 1104098987. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1307 E ELM ST
ATHENS, AL
ZIP 35611-318
Phone: (256) 232-3661
Fax: (256) 355-6092

The enumeration date for this NPI number is 4/1/2008 and was last updated on 7/16/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
151547790OTHERBCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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