Healthcare Provider Details

I. General information

NPI: 1649191214
Provider Name (Legal Business Name): MADISON HANNI LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18291 US HIGHWAY 31
CULLMAN AL
35058-0218
US

IV. Provider business mailing address

18291 US HIGHWAY 31
CULLMAN AL
35058-0218
US

V. Phone/Fax

Practice location:
  • Phone: 256-709-4534
  • Fax:
Mailing address:
  • Phone: 256-709-4534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6957C
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: