Provider Demographics
NPI:1235858960
Name:PODOS, MADDISON JOELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:MADDISON
Middle Name:JOELLE
Last Name:PODOS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4737 KESTER AVE APT 201
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2097
Mailing Address - Country:US
Mailing Address - Phone:520-271-7553
Mailing Address - Fax:
Practice Address - Street 1:4737 KESTER AVE APT 201
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-2097
Practice Address - Country:US
Practice Address - Phone:520-271-7553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA763441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical