Healthcare Provider Details

I. General information

NPI: 1750164182
Provider Name (Legal Business Name): MADDISON KIRSCHNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MADDISON MEDEIROS

II. Dates (important events)

Enumeration Date: 08/17/2023
Last Update Date: 12/14/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

828 ANDREWS AVE STE 2
OZARK AL
36360-3706
US

IV. Provider business mailing address

828 ANDREWS AVE STE 2
OZARK AL
36360-3706
US

V. Phone/Fax

Practice location:
  • Phone: 334-443-1030
  • Fax: 334-751-1466
Mailing address:
  • Phone: 334-545-4586
  • Fax: 334-751-1466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberL715
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: