Healthcare Provider Details

I. General information

NPI: 1841113776
Provider Name (Legal Business Name): MADALYN MAE KIRCHOFF LLMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 MEDICAL CENTER DR
CARLETON MI
48117-9461
US

IV. Provider business mailing address

130 MEDICAL CENTER DR
CARLETON MI
48117-9461
US

V. Phone/Fax

Practice location:
  • Phone: 734-654-2169
  • Fax:
Mailing address:
  • Phone: 734-654-2169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851121733
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: