Provider Demographics
NPI:1922759943
Name:KUYKENDALL, MADISON (MSW)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:KUYKENDALL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25140 HIGHWAY 18 N
Mailing Address - Street 2:
Mailing Address - City:TOONE
Mailing Address - State:TN
Mailing Address - Zip Code:38381-8114
Mailing Address - Country:US
Mailing Address - Phone:731-300-2280
Mailing Address - Fax:
Practice Address - Street 1:25140 HIGHWAY 18 N
Practice Address - Street 2:
Practice Address - City:TOONE
Practice Address - State:TN
Practice Address - Zip Code:38381-8114
Practice Address - Country:US
Practice Address - Phone:731-300-2280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker