Provider Demographics
NPI:1518850189
Name:BICKFORD, MADELYN BLAIR
Entity type:Individual
Prefix:
First Name:MADELYN
Middle Name:BLAIR
Last Name:BICKFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5460 CARTERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:NEW CANTON
Mailing Address - State:VA
Mailing Address - Zip Code:23123-2289
Mailing Address - Country:US
Mailing Address - Phone:434-808-4382
Mailing Address - Fax:
Practice Address - Street 1:17039 OAK ST
Practice Address - Street 2:
Practice Address - City:DILLWYN
Practice Address - State:VA
Practice Address - Zip Code:23936-3019
Practice Address - Country:US
Practice Address - Phone:434-394-0703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician