Provider Demographics
NPI:1891495107
Name:NOLA, MADISON (LSW)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:NOLA
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4067 CLEAR CREEK DR
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-2182
Mailing Address - Country:US
Mailing Address - Phone:716-994-3069
Mailing Address - Fax:
Practice Address - Street 1:2921 W 120TH AVE UNIT 100
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-2944
Practice Address - Country:US
Practice Address - Phone:888-528-3680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW.00099253171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical