MEDICARE: MADISON THORSON MA, BCBA

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
1	103K00000X	Behavior Analyst		IA

General Provider Information

NPI Number	:	1306620505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON THORSON MA, BCBA

Provider Business Mailing Address
First Line	:	60 JEFFERSON ST APT 11
Second Line	:
City	:	NORTH LIBERTY
State	:	IA
Zip	:	52317-9098
Country	:	US
Telephone Number	:	949-870-6034
Fax Number	:

Provider Business Practice Location Address
First Line	:	2545 N DODGE ST STE A
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52245-9558
Country	:	US
Telephone Number	:	319-727-8202
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2023
Last Update Date	:	06/18/2025

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