Individual
MADISON KNOWLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LMHC, LPC, LCPC
Contact information
Practice address
1170 E 800 N, SHELLEY, ID 83274-5356
(772) 284-1873
Mailing address
1170 E 800 N, SHELLEY, ID 83274-5356
(732) 606-6984
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0019934
CO
101YM0800X
Mental Health Counselor
10663-125
WI
101YM0800X
Mental Health Counselor
Primary
LCPC-9941
ID
101YM0800X
Mental Health Counselor
MH22655
FL
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
12/28/2011
Last updated
05/02/2024
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