Healthcare Provider Details

I. General information

NPI: 1417871344
Provider Name (Legal Business Name): MADISON BROWN BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

354 HIGHLAND RIDGE DR
HARTWELL GA
30643-3777
US

IV. Provider business mailing address

354 HIGHLAND RIDGE DR
HARTWELL GA
30643-3777
US

V. Phone/Fax

Practice location:
  • Phone: 706-514-6250
  • Fax: 706-995-6827
Mailing address:
  • Phone: 706-514-6250
  • Fax: 706-995-6827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2832694
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: