Madison Waller

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

14153492-6006 Issued in UT

Practice address

3809 W 6200 S
Taylorsville, UT 84129-3725

Phone

(801) 963-4360

NPI assigned

Sep 9, 2024

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1992531883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3725 W 4100 S STE 201",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841205427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3809 W 6200 S",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841293725",
            "telephone_number": "801-963-4360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "MADISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "UT",
            "license": "14153492-6006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Walker
• Kristan Walker
• Wesley Paul Walker, P.T.
• Eliza Mae Walkoviak
• Madeline Wallace
• Walmart Inc.
• Leela Walser
• Makayla Walsh
• Gabriela Walsman Leiva, M.D.
• Jacob Walster

• All providers in Taylorsville, UT
• Addiction (Substance Use Disorder) Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.