Organization
MODERN THERAPY MADISON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY HOLDER LPC (OWNER)
(608) 616-5018
Entity
Organization
Contact information
Practice address
9314 GOLDEN HUE BLVD, MADISON, WI 53593
(608) 616-5019
Mailing address
6666 ODANA RD # 233, MADISON, WI 53719-1012
(608) 616-5018
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
11/09/2022
Last updated
04/17/2023
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