Healthcare Provider Details

I. General information

NPI: 1780317446
Provider Name (Legal Business Name): MADISON JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2022
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8527 MAYLAND DR STE 108
HENRICO VA
23294-4753
US

IV. Provider business mailing address

1230 MOUNTAIN VIEW DR APT F
HARRISONBURG VA
22801-4452
US

V. Phone/Fax

Practice location:
  • Phone: 804-404-9695
  • Fax: 804-510-0044
Mailing address:
  • Phone: 804-592-7165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: