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General NPI Number Information
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NPI Number | 1619820289
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Entity Type | Individual
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Provider Name | MADELINE ELIZABETH MCCONVILLE
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Gender | Female
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Dates
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Enumeration Date | 02/16/2026
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Last Update Date | 02/16/2026
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Provider Practice Location Address
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Address Line | 3936 CIRCLE DR
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City | HOLMEN
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State | WI
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Zip | 54636-9187
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Country | US
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Telephone | 507-450-3080
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Fax |
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Provider Business Mailing Address
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Address Line | 22727 COUNTY ROAD 15
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City | WINONA
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State | MN
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Zip | 55987-5593
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Country | US
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Telephone | 507-450-3080
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | WI
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