Provider Demographics
NPI:1033282264
Name:MADISON, ALMA MAEARTIS (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ALMA
Middle Name:MAEARTIS
Last Name:MADISON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ALMA
Other - Middle Name:MAEARTIS
Other - Last Name:MCCLURE-GRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:2877 RAINBOW RIVER DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89142-3670
Mailing Address - Country:US
Mailing Address - Phone:510-689-4419
Mailing Address - Fax:
Practice Address - Street 1:4535 W RUSSELL RD STE 15
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-2258
Practice Address - Country:US
Practice Address - Phone:702-368-2380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60127390200000X
NV8650-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program