Provider Demographics
NPI:1053709337
Name:HALVERSON, MADISON (TLMHC)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:HALVERSON
Suffix:
Gender:F
Credentials:TLMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 JONES ST APT 6
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-1149
Mailing Address - Country:US
Mailing Address - Phone:402-650-8323
Mailing Address - Fax:
Practice Address - Street 1:22060 221ST ST
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:IA
Practice Address - Zip Code:51534-5389
Practice Address - Country:US
Practice Address - Phone:712-527-2823
Practice Address - Fax:712-527-4193
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-08
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA132950101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor