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NPI Code Detail

MEDICARE: MADISON LEGG

MEDICARE:   MADISON  LEGG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorC.2607640-TRNEOH

General Provider Information

NPI Number : 1184566648
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADISON LEGG
Provider Business Mailing Address
First Line : 3951 ROCKY RIVER DR
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-4154
Country : US
Telephone Number : 216-675-6360
Fax Number :
Provider Business Practice Location Address
First Line : 3951 ROCKY RIVER DR
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-4154
Country : US
Telephone Number : 216-675-6360
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2026
Last Update Date : 04/06/2026

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Directions to “ MADISON LEGG ” Practice Location

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