Provider Demographics
NPI:1003824327
Name:MADISON, WILLIAM E (LMSW)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:E
Last Name:MADISON
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 ROCKWOOD PL
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-1306
Mailing Address - Country:US
Mailing Address - Phone:914-235-1055
Mailing Address - Fax:
Practice Address - Street 1:VA HUDSON VALLEY HCS
Practice Address - Street 2:2094 ALBANY POST ROAD
Practice Address - City:MONTROSE
Practice Address - State:NY
Practice Address - Zip Code:10548
Practice Address - Country:US
Practice Address - Phone:914-737-4400
Practice Address - Fax:914-788-4286
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038860101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY038860OtherSTATE LICENSE-SOCIAL WORK