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Individual

MR. JONATHAN DANIEL MADILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
1507 E RACE AVE, SEARCY, AR 72143-4661
(501) 305-2359
(501) 305-2348
Mailing address
1815 PLEASANT GROVE RD, JONESBORO, AR 72401-7870
(870) 933-6886
(870) 933-9395

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
101YP2500X
Professional Counselor
P1601009
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A1105051
LAC
AR
Enumeration date
04/18/2012
Last updated
10/20/2016
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