Madison Sports, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1003 Mary St
Waycross, GA 31503-3823

Phone

(912) 449-7100

NPI assigned

May 27, 2025

Last updated

May 27, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Unison Behavioral Health

  • Community/Behavioral Health Agency
  • Waycross, GA
  • NPI 1528104866
  Medicare reassignment NPD
• Unison Behavioral Health

  • Counselor
  • Homerville, GA
  • NPI 1427368539
  NPD
• Unison Behavioral Health

  • Community/Behavioral Health Agency
  • Waycross, GA
  • NPI 1073650115
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1748304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1023801529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 MARY ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315033823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 MARY ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315033823",
            "telephone_number": "912-449-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPORTS",
        "first_name": "MADISON",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-27",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Nurse Anesthesiology, LLC
• Speech Clinic LLC
• Speech-Language Pathology Contractors, Inc.
• Sonda Sperzel, LPC
• Sports Medicine and Rehab Therapy, LLC (SMaRT Physical Therapy)
• Jason Springer, D.O
• Prasanna Sampurna Srinagesh, M.D.
• Viva Steed
• James Herbert Stevenot Sr., OD
• Lauren Stevens, RN

• Mental Health Counselor in Waycross, GA
• Providers in Waycross, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.