MEDICARE: MADISON POWELL MSED

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	101YP2500X	Professional Counselor	0704018994	VA

General Provider Information

NPI Number	:	1386591600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON POWELL MSED

Provider Business Mailing Address
First Line	:	1017 48TH ST APT X
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23508-1962
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7304 HAMPTON BLVD APT A
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23505-2924
Country	:	US
Telephone Number	:	757-780-7900
Fax Number	:

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

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	06/05/2026

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