Healthcare Provider Details

I. General information

NPI: 1548174717
Provider Name (Legal Business Name): MADISON RHOADS MS, LBS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 EDEN RD
LANCASTER PA
17601-4713
US

IV. Provider business mailing address

325 W WALNUT ST
LANCASTER PA
17603-2932
US

V. Phone/Fax

Practice location:
  • Phone: 717-894-8388
  • Fax:
Mailing address:
  • Phone: 717-319-1663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBH008804
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: