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General NPI Number Information
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NPI Number | 1245499607
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Entity Type | Individual
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Provider Name | ELIZABETH LOUISE MADISON LMHC, CAP
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Gender | Female
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Dates
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Enumeration Date | 06/02/2008
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Last Update Date | 06/22/2022
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Provider Practice Location Address
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Address Line | 4300 SW 13TH ST
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City | GAINESVILLE
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State | FL
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Zip | 32608-4006
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Country | US
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Telephone | 352-374-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 2208 NE 3RD ST APT 201
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City | OCALA
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State | FL
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Zip | 34470-8285
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Country | US
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Telephone | 352-454-6868
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ADC-0019022014
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH 14211
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License Number State | FL
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