Provider Demographics
NPI:1124554035
Name:CARR, MADISON SMITH (MSW)
Entity Type:Individual
Prefix:MRS
First Name:MADISON
Middle Name:SMITH
Last Name:CARR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MISS
Other - First Name:MADISON
Other - Middle Name:LEIGH
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW
Mailing Address - Street 1:7130 HODGSON MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-1526
Mailing Address - Country:US
Mailing Address - Phone:912-355-3881
Mailing Address - Fax:912-355-3388
Practice Address - Street 1:7130 HODGSON MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-1526
Practice Address - Country:US
Practice Address - Phone:912-355-3881
Practice Address - Fax:912-355-3887
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical