Madison Janemarie Bagwell

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

8680 Issued in SC

Practice address

890 Johnnie Dodds Blvd
Building 3, Suite a
Mount Pleasant, SC 29464

Phone

(843) 884-3888

NPI assigned

Jan 8, 2024

Last updated

Jan 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Madison Janemarie Bonifield Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Seeds of Life

  dba Life Resources

  • Professional Counselor
  • Mount Pleasant, SC
  • NPI 1730408634
  NPD (past)

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1528838778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 3RD AVE",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294642702",
            "telephone_number": "703-727-3139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 JOHNNIE DODDS BLVD",
            "address_2": "BUILDING 3, SUITE A",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "29464",
            "telephone_number": "843-884-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGWELL",
        "first_name": "MADISON",
        "middle_name": "JANEMARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "8680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADISON",
            "last_name": "BONIFIELD",
            "middle_name": "JANEMARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Theresa Baek, RPH
• Brianna Lynn Bagdasian
• Andrew Bagley, PT, DPT, OCS, ATC
• Kristen Bagley, LISW-CP
• Sarah Bagley, OTR/L
• Yuehan Bai, MASSAGE THERAPIST
• Bailey Weightman, DDS, MSD, LLC
• Kelly Langan Bailey, MS.SLP/CCC, MA. BCBA
• Kyla Bailey, BCBA
• Marjorie Dawson Bailey, RN

• Mental Health Counselor in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.