Individual
DEANNA J MADISON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LPC, LPA
Contact information
Practice address
103 FOUNTAINHEAD LN, FAYETTEVILLE, NC 28301-5462
(910) 483-3373
(910) 426-3921
Mailing address
PO BOX 58362, FAYETTEVILLE, NC 28305-8362
(910) 483-3373
(910) 426-3921
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3207
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130RK
BLUE CROSS BLUE SHIELD
NC
01
—
196506
COMPSYCH
NC
05
—
6107085
—
NC
Enumeration date
01/16/2006
Last updated
07/08/2007
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