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General NPI Number Information
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NPI Number | 1679431415
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Entity Type | Individual
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Provider Name | MADISON ANNE ELLIS LMSW
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Gender | Female
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 1123 1ST AVE E STE 200
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City | NEWTON
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State | IA
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Zip | 50208-3981
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Country | US
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Telephone | 641-792-4012
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Fax |
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Provider Business Mailing Address
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Address Line | 616 EAST ST S
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City | GRINNELL
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State | IA
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Zip | 50112-8079
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Country | US
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Telephone | 641-990-4395
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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 | 127805
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License Number State | IA
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