Provider Demographics
NPI:1225640469
Name:LAMPKINS, MADARIO
Entity Type:Individual
Prefix:
First Name:MADARIO
Middle Name:
Last Name:LAMPKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4322 CREEKDALE DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-8258
Mailing Address - Country:US
Mailing Address - Phone:336-814-6468
Mailing Address - Fax:
Practice Address - Street 1:2311 W CONE BLVD STE 223
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-4067
Practice Address - Country:US
Practice Address - Phone:336-542-2884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0150661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical