MEDICARE: MADELAINE NEWMAN BCBA

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	103K00000X	Behavior Analyst	1-23-67376
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1356921035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADELAINE NEWMAN BCBA

Provider Business Mailing Address
First Line	:	27777 INKSTER RD STE 100
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-5312
Country	:	US
Telephone Number	:	855-772-8847
Fax Number	:

Provider Business Practice Location Address
First Line	:	8615 CLIFF CAMERON DR STE 200
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-5914
Country	:	US
Telephone Number	:	855-772-8847
Fax Number	:

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

Provider Enumeration Date	:	04/08/2021
Last Update Date	:	09/04/2025

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Directions to “ MADELAINE NEWMAN BCBA” Practice Location

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