MEDICARE: MADISON MORLEY LPC-ASSOCIATE

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	101YP2500X	Professional Counselor	93477	TX

General Provider Information

NPI Number	:	1952162976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON MORLEY LPC-ASSOCIATE

Provider Business Mailing Address
First Line	:	PO BOX 121835
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-7835
Country	:	US
Telephone Number	:	855-579-5323
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 E RANDOL MILL RD STE 100
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76011-5800
Country	:	US
Telephone Number	:	855-579-5323
Fax Number	:

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

Provider Enumeration Date	:	01/17/2024
Last Update Date	:	01/17/2024

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