Individual
JEANINE MADSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
THERAPIST, LPC
Contact information
Practice address
37450 SCHOOLCRAFT RD STE 170, LIVONIA, MI 48150-1081
(734) 744-0170
Mailing address
18270 CASCADE DR, NORTHVILLE, MI 48168-3287
(734) 776-7738
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
6401014963
MI
101YP2500X
Professional Counselor
Primary
6401014963
MI
Other
Enumeration date
09/09/2014
Last updated
10/21/2019
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