MEDICARE: MADISON STELLY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	10162	LA

General Provider Information

NPI Number	:	1164354585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON STELLY

Provider Business Mailing Address
First Line	:	PO BOX 1593
Second Line	:
City	:	SAINT FRANCISVILLE
State	:	LA
Zip	:	70775-1593
Country	:	US
Telephone Number	:	225-245-5170
Fax Number	:	225-308-3223

Provider Business Practice Location Address
First Line	:	PO BOX 1593
Second Line	:
City	:	SAINT FRANCISVILLE
State	:	LA
Zip	:	70775-1593
Country	:	US
Telephone Number	:	225-245-5170
Fax Number	:	225-308-3223

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ MADISON STELLY ” Practice Location

Language	Start Address	Practice Location

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