Healthcare Provider Details

I. General information

NPI: 1962338475
Provider Name (Legal Business Name): MADISON KAY BUNCE WILNER LISW-CP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 E BOUNDARY ST
CHAPIN SC
29036-8386
US

IV. Provider business mailing address

941 BANNOCKBURN DR
LEXINGTON SC
29073-6112
US

V. Phone/Fax

Practice location:
  • Phone: 803-446-0084
  • Fax:
Mailing address:
  • Phone: 803-260-3260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number18425
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: