Provider Demographics
NPI:1104715937
Name:OFELIA MADRIGAL
Entity type:Organization
Organization Name:OFELIA MADRIGAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MFTI
Authorized Official - Prefix:MRS
Authorized Official - First Name:OFELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MADRIGAL
Authorized Official - Suffix:
Authorized Official - Credentials:MFTI
Authorized Official - Phone:559-331-4110
Mailing Address - Street 1:125 CORONATION AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-1153
Mailing Address - Country:US
Mailing Address - Phone:559-331-4110
Mailing Address - Fax:
Practice Address - Street 1:2470 SAINT ROSE PKWY # 320
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7772
Practice Address - Country:US
Practice Address - Phone:725-277-2266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-27
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty