Provider Demographics
NPI:1619326634
Name:MESSERLI, MADISON (LCSW)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:MESSERLI
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 1:4773 CAUGHLIN PKWY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89519-1011
Mailing Address - Country:US
Mailing Address - Phone:775-221-7400
Mailing Address - Fax:775-657-6551
Practice Address - Street 1:4773 CAUGHLIN PKWY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89519-1011
Practice Address - Country:US
Practice Address - Phone:775-221-7400
Practice Address - Fax:775-657-6551
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NVIC-1452104100000X
NV8493-M1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker