MEDICARE: MADDEN & LYLE CASE MANAGEMENT CONSULTING AGENCY LLC

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1508719022
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MADDEN & LYLE CASE MANAGEMENT CONSULTING AGENCY LLC

Provider Business Mailing Address
First Line	:	2321 SIR BARTON WAY STE 140
Second Line	:	# 1157
City	:	LEXINGTON
State	:	KY
Zip	:	40509-2437
Country	:	US
Telephone Number	:	859-519-9989
Fax Number	:

Provider Business Practice Location Address
First Line	:	441 HAYS BLVD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-4496
Country	:	US
Telephone Number	:	859-519-9989
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	DARA JACKSON
Credential	:	MSW
Telephone Number	:	859-519-9989

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

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