Individual
MADISON E CECULSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2655 S LAKE ERIE DR STE B, SALT LAKE CITY, UT 84120-7351
(385) 441-4900
Mailing address
2655 S LAKE ERIE DR STE B, WEST VALLEY CITY, UT 84120-7351
(385) 441-4900
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13853757-3501
UT
171M00000X
Case Manager/Care Coordinator
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000
LICENSURE BOARD
OH
Enumeration date
05/23/2018
Last updated
01/16/2026
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