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General NPI Number Information
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NPI Number | 1477444776
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Entity Type | Individual
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Provider Name | MADELAINE PEREZ
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Gender | Female
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Dates
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Enumeration Date | 07/14/2025
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 6885 CLIFFDALE RD STE 202
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-2834
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Country | US
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Telephone | 910-339-0400
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Fax | 910-339-0396
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Provider Business Mailing Address
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Address Line | 6115 INDEPENDENCE PLACE DR APT 712
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-4756
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Country | US
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Telephone | 630-546-4292
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | A21720
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License Number State | NC
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