Healthcare Provider Details

I. General information

NPI: 1750175022
Provider Name (Legal Business Name): MADISON BRIANNA BATTS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 MALLOY ST STE E
GOLDSBORO NC
27534-4478
US

IV. Provider business mailing address

1404 E WALNUT ST
GOLDSBORO NC
27530-5238
US

V. Phone/Fax

Practice location:
  • Phone: 919-778-5594
  • Fax: 919-778-5633
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC018114
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberC018114
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: