Individual provider Active NPI

Madison Brawley, MS, NCC,LPC

  • Professional Counselor
  • Ellington, MO
National Provider Identifier
1063970283
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
315 E Walnut St
Ellington, MO 63638-7943
Phone
(573) 663-2644
NPI assigned
Mar 6, 2019
Last updated
Apr 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

315 E Walnut St
Ellington, MO 63638-7943

Mailing address

315 E Walnut St
Ellington, MO 63638-7943
Phone (573) 663-2644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240307003269 MO Practitioner - Mental Health Counselor 1850737263 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Counseling Center IncGroup PAC ID 2163410481, 39 clinicians

Practice addresses (Care Compare)

315 E Walnut St
Ellington, MO 63638-7943
Phone (573) 663-2644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Betty and Bobby Allison Ozarks Counseling Center Counselor CurrentSince Jan 22, 2024 Accepting new patients
Family Counseling Center, Inc. CurrentSince Apr 9, 2024 Accepting new patients
Family Counseling Center, Inc. CurrentSince Apr 9, 2024 Accepting new patients

Locations

315 E Walnut St
Ellington, MO 63638
Phone (573) 663-2500

5 Sugar Creek Rd
Piedmont, MO 63957
Phone (573) 223-4169

3001 Warrior Ln
Poplar Bluff, MO 63901
Phone (573) 785-7453

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1063970283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 E WALNUT ST",
            "city": "ELLINGTON",
            "state": "MO",
            "postal_code": "636387943",
            "telephone_number": "573-663-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E WALNUT ST",
            "city": "ELLINGTON",
            "state": "MO",
            "postal_code": "636387943",
            "telephone_number": "573-663-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAWLEY",
        "first_name": "MADISON",
        "credential": "MS, NCC,LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-06",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellington, MO

Sources for this page

Verify at the official NPI Registry.