Basic Information
| Provider Information | |||||||||
| NPI: | 1952357907 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VADEN | ||||||||
| FirstName: | GILES | ||||||||
| MiddleName: | HENRY | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MS | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 140 FIELDS POND DRIVE | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2563340435 | ||||||||
| FaxNumber: | 2059688373 | ||||||||
| Practice Location | |||||||||
| Address1: | 140 FIELDS POND DRIVE | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2563340435 | ||||||||
| FaxNumber: | 2059688373 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2006 | ||||||||
| LastUpdateDate: | 02/27/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 246YC3302X | N | Technologists, Technicians & Other Technical Service Providers | Spec/Tech, Health Info | Coding Specialist, Physician Office Based | 101Y00000X | 372 | AL | Y | Behavioral Health & Social Service Providers | Counselor |
ID Information
| ID | Type | State | Issuer | Description | 92797 | 01 | AL | BCBS | OTHER | 92764 | 01 | AL | BCBS | OTHER |