Healthcare Provider Details

I. General information

NPI: 1871279299
Provider Name (Legal Business Name): MADYSON F HARP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MADYSON FAITH DEPOY RBT

II. Dates (important events)

Enumeration Date: 06/22/2023
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4154 MENDENHALL OAKS PKWY STE 101
HIGH POINT NC
27265-8426
US

IV. Provider business mailing address

4154 MENDENHALL OAKS PKWY STE 101
HIGH POINT NC
27265-8426
US

V. Phone/Fax

Practice location:
  • Phone: 336-884-9510
  • Fax: 336-884-9518
Mailing address:
  • Phone: 336-884-9510
  • Fax: 336-884-9518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: