Provider Demographics
NPI:1356693097
Name:HUSMAN, MADISON AMBER (T-LPC)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:AMBER
Last Name:HUSMAN
Suffix:
Gender:F
Credentials:T-LPC
Other - Prefix:
Other - First Name:MADISON
Other - Middle Name:AMBER
Other - Last Name:MAXWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5401 SW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606
Mailing Address - Country:US
Mailing Address - Phone:785-273-2252
Mailing Address - Fax:785-273-7489
Practice Address - Street 1:400 SW OAKLEY AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606
Practice Address - Country:US
Practice Address - Phone:785-233-1730
Practice Address - Fax:785-354-1068
Is Sole Proprietor?:No
Enumeration Date:2012-10-04
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3150101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1841281805Medicare UPIN
KS1841281805Medicaid