Provider Demographics
NPI:1154995884
Name:WINKLE, MADISON HOPE (LPCC, LAC)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:HOPE
Last Name:WINKLE
Suffix:
Gender:F
Credentials:LPCC, LAC
Other - Prefix:
Other - First Name:MADISON
Other - Middle Name:HOPE
Other - Last Name:MCGONIGAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4023 STATE ST STE 65
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0638
Mailing Address - Country:US
Mailing Address - Phone:701-299-3353
Mailing Address - Fax:
Practice Address - Street 1:4023 STATE ST STE 65
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0638
Practice Address - Country:US
Practice Address - Phone:701-299-3353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1942101YA0400X
ND1063-5-1-20-480101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)