MEDICARE: MADALYN MARIE STUCKER

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	BBH-SWLC-LIC-80942	MT

General Provider Information

NPI Number	:	1285511691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADALYN MARIE STUCKER

Provider Business Mailing Address
First Line	:	225 7TH AVE S STE 1
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59405-1820
Country	:	US
Telephone Number	:	406-453-5592
Fax Number	:

Provider Business Practice Location Address
First Line	:	305 8TH ST N STE A
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59401-1517
Country	:	US
Telephone Number	:	406-268-7230
Fax Number	:

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

Provider Enumeration Date	:	08/18/2025
Last Update Date	:	08/18/2025

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Directions to “ MADALYN MARIE STUCKER ” Practice Location

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