1447132907 NPI number — MADELINE KIOUSIS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447132907 NPI number — MADELINE KIOUSIS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KIOUSIS
Provider First Name:
MADELINE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447132907
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/31/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7467 CARATOKE HWY STE 1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JARVISBURG
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27947-9708
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
252-255-2733
Provider Business Mailing Address Fax Number:
252-255-0787

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7467 CARATOKE HWY STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JARVISBURG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27947-9708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-255-2733
Provider Business Practice Location Address Fax Number:
252-255-0787
Provider Enumeration Date:
07/24/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  P024488 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P024488 . This is a "LCSW" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




Copyright © 2007-2026 www.npivalidator.com