Provider Demographics
NPI:1891594172
Name:AUGUST, MADISON HAILEY (BS, CADC-R, CRM)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:HAILEY
Last Name:AUGUST
Suffix:
Gender:
Credentials:BS, CADC-R, CRM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14935 SE 82ND DR
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-9624
Mailing Address - Country:US
Mailing Address - Phone:503-343-8657
Mailing Address - Fax:
Practice Address - Street 1:14935 SE 82ND DR
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-9624
Practice Address - Country:US
Practice Address - Phone:503-343-8657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)