Provider Demographics
NPI:1053287854
Name:APPLEBA, MADISON NICHOLE (LCSW)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:NICHOLE
Last Name:APPLEBA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 E MAIN ST STE 2E
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-5749
Mailing Address - Country:US
Mailing Address - Phone:423-430-9362
Mailing Address - Fax:423-830-0767
Practice Address - Street 1:207 E MAIN ST STE 2E
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-5749
Practice Address - Country:US
Practice Address - Phone:423-430-9362
Practice Address - Fax:423-830-0767
Is Sole Proprietor?:No
Enumeration Date:2025-10-17
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN251S00000X101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health