Provider Demographics
NPI:1043837016
Name:FLOYD, MADISON MARIE (LMSW)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:MARIE
Last Name:FLOYD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 E SHERMAN AVE STE 2B
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2770
Mailing Address - Country:US
Mailing Address - Phone:208-273-9147
Mailing Address - Fax:
Practice Address - Street 1:601 E SHERMAN AVE STE 2B
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2770
Practice Address - Country:US
Practice Address - Phone:208-273-9147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-25
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
ID0172V00000X
ID82711601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAFLOYDMM029JLOtherDRIVERS LICENSE