Healthcare Provider Details

I. General information

NPI: 1427931682
Provider Name (Legal Business Name): MADISON LYNN HARRIS LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 07/28/2025
Certification Date: 07/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 SPRINGDALE DR
EXTON PA
19341-2941
US

IV. Provider business mailing address

3813 COLE AVE
HIGH POINT NC
27265-8027
US

V. Phone/Fax

Practice location:
  • Phone: 984-230-2323
  • Fax:
Mailing address:
  • Phone: 336-880-8061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.2410756
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: