Provider Demographics
NPI:1508919937
Name:MADSON, SARAH L (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:L
Last Name:MADSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 865
Mailing Address - Street 2:
Mailing Address - City:APALACHICOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32329-0865
Mailing Address - Country:US
Mailing Address - Phone:407-267-1060
Mailing Address - Fax:
Practice Address - Street 1:41 COMMERCE ST UNIT B
Practice Address - Street 2:
Practice Address - City:APALACHICOLA
Practice Address - State:FL
Practice Address - Zip Code:32320-1771
Practice Address - Country:US
Practice Address - Phone:407-267-1060
Practice Address - Fax:850-653-1602
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7417103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical