David Mark Madison, MALLP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6361006967 Issued in MI

Practice address

19445 W Warren Ave
Detroit, MI 48228-3361

Phone

(313) 307-0088

Fax

(313) 281-2235

NPI assigned

Nov 27, 2017

Sex

Male

Sole proprietor

Yes

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 MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Asnaa

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Detroit, MI
  • NPI 1346637758

  Psychologist

  Medicare reassignment NPD
• Iamerica Wellness Center

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Canton, MI
  • NPI 1801765946

  Behavior Analyst

  NPD (past)
• Richard Kneip, PH.D., P.C.

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  NPD (past)

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

{
    "created_epoch": "1511740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653091200000",
    "number": "1497269609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19445 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482283361",
            "telephone_number": "313-307-0088",
            "fax_number": "313-281-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19445 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482283361",
            "telephone_number": "313-307-0088",
            "fax_number": "313-281-2235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADISON",
        "first_name": "DAVID",
        "middle_name": "MARK",
        "credential": "MALLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-27",
        "last_updated": "2022-05-21",
        "certification_date": "2022-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6361006967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Community Hospital Inc
• Madison Community Hospital, Inc.
• Madison Oaks Home Care LLC
• Charles Edward Madison Jr., LLBSW
• Connie Madison
• Amna Madni, MD
• Madonna Acquisition Company Inc.
• Edith Maduka, LLMSW
• Koichi Maeda, M.D.
• Diane L Maennle, MD

• Psychologist in Detroit, MI
• Providers in Detroit, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.