Provider Demographics
NPI:1609347442
Name:HERSHBERGER, MADELYN JOY (LPC)
Entity Type:Individual
Prefix:
First Name:MADELYN
Middle Name:JOY
Last Name:HERSHBERGER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 SW LONGVIEW BLVD STE 160
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-2112
Mailing Address - Country:US
Mailing Address - Phone:816-761-3944
Mailing Address - Fax:
Practice Address - Street 1:400 SW LONGVIEW BLVD STE 160
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-2112
Practice Address - Country:US
Practice Address - Phone:816-761-3944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018041818101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health