Active NPI
Madonna McConnell
- Addiction (Substance Use Disorder) Counselor
- Poplar, MT
National Provider Identifier
1053858001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- BBH-LAC-LIC3451
- Practice address
- 603 1/2 Court Avenue
Poplar, MT 59255 - Phone
- (406) 768-5364
- Fax
- (406) 768-5202
- NPI assigned
- Jan 30, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | BBH-LAC-LIC3451 | MT | Primary |
Addresses
Primary practice location
603 1/2 Court Avenue
Poplar, MT 59255
Mailing address
603 1/2 Court Avenue
Poplar, MT 59255
Phone (406) 768-5364
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BBH-LAC-LIC3451 | MT | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485734400000",
"number": "1053858001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "603 1/2 COURT AVENUE",
"city": "POPLAR",
"state": "MT",
"postal_code": "59255",
"telephone_number": "406-768-5364",
"fax_number": "406-768-5202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "603 1/2 COURT AVENUE",
"city": "POPLAR",
"state": "MT",
"postal_code": "59255",
"telephone_number": "406-768-5364",
"fax_number": "406-768-5202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCONNELL",
"first_name": "MADONNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-30",
"last_updated": "2017-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MT",
"license": "BBH-LAC-LIC3451",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poplar, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.