Provider Demographics
NPI:1588302483
Name:MADISON PSYCHIATRY SERVICES LLC
Entity type:Organization
Organization Name:MADISON PSYCHIATRY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:KRISTINE
Authorized Official - Last Name:HOLLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-640-2614
Mailing Address - Street 1:953 JEFF RD NW BLDG 1
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-1237
Mailing Address - Country:US
Mailing Address - Phone:256-332-6272
Mailing Address - Fax:256-322-4987
Practice Address - Street 1:540 HUGHES RD STE 11
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-8959
Practice Address - Country:US
Practice Address - Phone:256-482-6868
Practice Address - Fax:256-216-4606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-22
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty