Provider Demographics
NPI:1912798190
Name:MAD WORLD WELLNESS PLLC
Entity type:Organization
Organization Name:MAD WORLD WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:BADOUR
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:989-390-5646
Mailing Address - Street 1:5806 SAGE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:MI
Mailing Address - Zip Code:48756-9625
Mailing Address - Country:US
Mailing Address - Phone:989-390-5646
Mailing Address - Fax:
Practice Address - Street 1:5806 SAGE LAKE RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:MI
Practice Address - Zip Code:48756-9625
Practice Address - Country:US
Practice Address - Phone:989-390-5646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty