Healthcare Provider Details

I. General information

NPI: 1013833714
Provider Name (Legal Business Name): EMILY MADIGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 VIRGINIA AVE NE STE 2
ATLANTA GA
30306-5125
US

IV. Provider business mailing address

3924 VINYARD WAY NE
MARIETTA GA
30062-5240
US

V. Phone/Fax

Practice location:
  • Phone: 678-400-9477
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: