MEDICARE: MADISON ANNE WOZNIAK LCSW, SW

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	C018950	NC
2	1041C0700X	Clinical Social Worker	149.027575	IL
3	1041C0700X	Clinical Social Worker	SW22801	FL

General Provider Information

NPI Number	:	1710734546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON ANNE WOZNIAK LCSW, SW

Provider Business Mailing Address
First Line	:	1340 FIRST EDITION DR UNIT 3009
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27703-0977
Country	:	US
Telephone Number	:	616-916-7974
Fax Number	:

Provider Business Practice Location Address
First Line	:	1120 S WILLIAMS ST APT B5
Second Line	:
City	:	WESTMONT
State	:	IL
Zip	:	60559-2947
Country	:	US
Telephone Number	:	616-916-7974
Fax Number	:

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

Provider Enumeration Date	:	04/30/2024
Last Update Date	:	03/24/2026

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