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General NPI Number Information
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NPI Number | 1538730031
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Entity Type | Individual
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Provider Name | MADISON M SIDWELL
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Gender | Female
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Dates
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Enumeration Date | 07/06/2021
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 1288 VALLEY FORGE RD STE 54
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City | PHOENIXVILLE
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State | PA
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Zip | 19460-2687
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Country | US
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Telephone | 267-563-8180
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 E PROSPECT RD BLDG A
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City | FORT COLLINS
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State | CO
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Zip | 80525-5304
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Country | US
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Telephone | 970-297-6630
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Fax | 970-297-6631
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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 | CSW.09931884
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW139725
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License Number State | PA
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