Raequel Allyssa Madara, PMHNP, LCSW

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

SP032464 Issued in PA

Practice address

527 E Lancaster Ave
Shillington, PA 19607-1364

Phone

(610) 796-8110

Fax

(610) 796-9130

NPI assigned

Mar 1, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Raequel Allyssa Forbes Former name

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Alternative Consulting Enterprises LLC.Group PAC ID 1759359540, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• Alternative Consulting Enterprises LLC

  • Community/Behavioral Health Agency
  • Shillington, PA
  • NPI 1831195932

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1362096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1427399377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 E GREENWOOD AVE",
            "city": "LANSDOWNE",
            "state": "PA",
            "postal_code": "190501621",
            "telephone_number": "610-368-7737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 E LANCASTER AVE",
            "city": "SHILLINGTON",
            "state": "PA",
            "postal_code": "196071364",
            "telephone_number": "610-796-8110",
            "fax_number": "610-796-9130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "145 E Greenwood Ave",
            "address_purpose": "LOCATION",
            "city": "Lansdowne",
            "state": "PA",
            "postal_code": "190501621",
            "country_code": "US",
            "telephone_number": "610-368-7737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADARA",
        "first_name": "RAEQUEL",
        "middle_name": "ALLYSSA",
        "name_prefix": "Mrs.",
        "credential": "PMHNP, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-01",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017538",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP032464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104516608-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAEQUEL",
            "last_name": "FORBES",
            "middle_name": "ALLYSSA",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Remi Minh Khang Le
• Jane Licatovich, MSCCCSLP
• Eric Ralph Lisbin, DC LAC
• Ping Jain Lisbin, LAC
• Tara Ludwig, LAT, ATC
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• Ronald M Martin, DMD
• Pamela Jo Mazza, COTA/L
• Lee McCarty, RPH
• Meghan McIntyre

• Psychiatric/Mental Health Nurse Practitioner in Shillington, PA
• Providers in Shillington, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.