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General NPI Number Information
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NPI Number | 1528769502
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Entity Type | Individual
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Provider Name | MADISON JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 03/15/2023
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 1138 PINE ST
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City | BURLINGTON
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State | VT
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Zip | 05401-5353
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Country | US
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Telephone | 802-488-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 1138 PINE ST
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City | BURLINGTON
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State | VT
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Zip | 05401-5353
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Country | US
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Telephone | 802-488-6000
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL06920900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 097.0139124
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License Number State | VT
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