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NPI Code Detail

MEDICARE: MADISON COLLIER

MEDICARE:   MADISON  COLLIER
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
11041C0700XClinical Social Worker6851120439MI

General Provider Information

NPI Number : 1396416327
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADISON COLLIER
Provider Business Mailing Address
First Line : 18726 S WESTERN AVE
Second Line :
City : GARDENA
State : CA
Zip : 90248-3813
Country : US
Telephone Number : 310-856-0800
Fax Number : 855-568-2494
Provider Business Practice Location Address
First Line : 12703 W 7 MILE RD
Second Line :
City : DETROIT
State : MI
Zip : 48235-1302
Country : US
Telephone Number : 313-694-3886
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2021
Last Update Date : 04/08/2026

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Directions to “ MADISON COLLIER ” Practice Location

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