Madison M Clodfelter

Individual provider Active NPI Behavior Technician · Longs, SC

NPI 1548073984 · NPPES record last updated Jan 29, 2025

Key facts

NPI
1548073984
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
80 Rolling River Rd
Longs, SC 29568-9498
Phone
(704) 550-8004
NPI assigned
Jan 29, 2025
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

80 Rolling River Rd
Longs, SC 29568-9498

Mailing address

80 Rolling River Rd
Longs, SC 29568-9498
Phone (704) 550-8004

Other providers in Longs, SC

All providers in Longs, SC · Behavior Technician in South Carolina

Sources for this page

Verify at the official NPI Registry.