Mary Lee Madison
Individual provider Active NPI Professional Counselor · Des Moines, IA
NPI 1780905422 · NPPES record last updated Apr 21, 2011
Key facts
- NPI
- 1780905422
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 1994 (OK)
- Practice address
- 1620 Pleasant St Ste 237
Des Moines, IA 50314-1676 - Phone
- (515) 244-1716
- Fax
- (515) 221-3519
- NPI assigned
- Jun 17, 2010
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12889 | TX | MD | Oral and Maxillofacial Surgery (Dentist) |
| 1994 | OK | MD | Surgical Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1994 | OK | Yes |
| Professional Counselor | 101YP2500X | 12889 | TX |
Addresses
Primary practice location
1620 Pleasant St Ste 237
Des Moines, IA 50314-1676
Mailing address
1620 Pleasant St Ste 237
Des Moines, IA 50314-1676
Phone (515) 244-1716
Other providers in Des Moines, IA
- Beth Maddy
- Asha Madia
- Madison County Medical Equipment, Inc
- Greg Charles Madison
- Jenna Madison
- Sarah Madojemu
- Courtney E Madonia
- Kristen Nicole Madsen
- Brandon E Madson
- Anthony E Magalski
All providers in Des Moines, IA · Professional Counselor in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 21, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.