Provider Demographics
NPI:1154459261
Name:MADISON, DENISE (MS MFT I)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:
Last Name:MADISON
Suffix:
Gender:F
Credentials:MS MFT I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5940 S RAINBOW BLVD
Mailing Address - Street 2:STE 1014
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-2506
Mailing Address - Country:US
Mailing Address - Phone:702-899-8212
Mailing Address - Fax:
Practice Address - Street 1:3620 N RANCHO DR STE 113
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3154
Practice Address - Country:US
Practice Address - Phone:562-977-8603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor