Provider Demographics
NPI:1851976591
Name:HARLOW, MADISON K (MA, LSC, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:K
Last Name:HARLOW
Suffix:
Gender:F
Credentials:MA, LSC, LPC, NCC
Other - Prefix:
Other - First Name:MADISON
Other - Middle Name:K
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2622 PIONEER AVE
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-3024
Mailing Address - Country:US
Mailing Address - Phone:970-924-0582
Mailing Address - Fax:
Practice Address - Street 1:2622 PIONEER AVE
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3024
Practice Address - Country:US
Practice Address - Phone:970-924-0582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-15
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO359329101YS0200X
CO0017809101YP2500X
WY101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool