Healthcare Provider Details

I. General information

NPI: 1235050139
Provider Name (Legal Business Name): MADISON LINK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5040 E SHEA BLVD STE 164
SCOTTSDALE AZ
85254-4686
US

IV. Provider business mailing address

4502 E PARADISE VILLAGE PKWY S APT 3050
PHOENIX AZ
85032-7734
US

V. Phone/Fax

Practice location:
  • Phone: 480-690-9532
  • Fax:
Mailing address:
  • Phone: 928-814-8253
  • Fax: 928-814-8253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: