MEDICARE: MRS. MEGAN FAITH MADDY 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

General Provider Information

NPI Number	:	1376051714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MEGAN FAITH MADDY BCBA

Provider Business Mailing Address
First Line	:	2525C LEBANON PIKE STE 102
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37214-2473
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2525C LEBANON PIKE STE 102
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37214-2473
Country	:	US
Telephone Number	:	615-516-3778
Fax Number	:

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

Provider Enumeration Date	:	01/19/2018
Last Update Date	:	01/14/2026

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