MEDICARE: MADISON MEYERSON LSCSW

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	1041C0700X	Clinical Social Worker	07162	KS

General Provider Information

NPI Number	:	1225764061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON MEYERSON LSCSW

Provider Business Mailing Address
First Line	:	4601 E DOUGLAS AVE STE 150
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67218-1011
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4601 E DOUGLAS AVE STE 150
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67218-1011
Country	:	US
Telephone Number	:	816-434-0493
Fax Number	:

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

Provider Enumeration Date	:	07/25/2022
Last Update Date	:	05/05/2026

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