Individual
MR. ANGELLO MADISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
114 N MAIN ST STE 102A, SUFFOLK, VA 23434-4564
(757) 921-2762
Mailing address
114 N MAIN ST STE 102A, SUFFOLK, VA 23434-4564
(757) 921-2762
(757) 257-1011
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
07010007132
VA
Other
Enumeration date
08/18/2008
Last updated
07/09/2021
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