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General NPI Number Information
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NPI Number | 1477476224
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Entity Type | Individual
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Provider Name | MADISYN ALANA JOLLY LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/30/2026
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Last Update Date | 07/30/2026
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Provider Practice Location Address
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Address Line | 2220 SHREVEPORT HWY
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City | PINEVILLE
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State | LA
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Zip | 71360-4041
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Country | US
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Telephone | 318-266-7021
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Fax |
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Provider Business Mailing Address
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Address Line | 2245 WIGGINS RD
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City | PINEVILLE
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State | LA
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Zip | 71360-9790
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Country | US
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Telephone | 318-792-8122
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 17194
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License Number State | LA
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