MEDICARE: MADELYN BLAIR REILLY

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	101YM0800X	Mental Health Counselor	PC016327	PA

General Provider Information

NPI Number	:	1962275503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADELYN BLAIR REILLY

Provider Business Mailing Address
First Line	:	127 GREENWOOD AVE
Second Line	:
City	:	AMBLER
State	:	PA
Zip	:	19002-4704
Country	:	US
Telephone Number	:	215-900-3983
Fax Number	:

Provider Business Practice Location Address
First Line	:	1018 N BETHLEHEM PIKE
Second Line	:
City	:	AMBLER
State	:	PA
Zip	:	19002-2186
Country	:	US
Telephone Number	:	215-900-3983
Fax Number	:

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

Provider Enumeration Date	:	11/06/2023
Last Update Date	:	02/17/2026

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