Healthcare Provider Details

I. General information

NPI: 1811721491
Provider Name (Legal Business Name): MADISON C MCNEIL PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MADDIE C MCNEIL

II. Dates (important events)

Enumeration Date: 08/27/2024
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17886 E 23RD ST S
INDEPENDENCE MO
64057-1840
US

IV. Provider business mailing address

PO BOX 844715
KANSAS CITY MO
64184-4715
US

V. Phone/Fax

Practice location:
  • Phone: 816-254-3652
  • Fax:
Mailing address:
  • Phone: 417-761-5214
  • Fax: 417-761-5065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number96109
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2025009232
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: