Provider Demographics
NPI:1861253098
Name:TOBIN, MADISON (LCMHCA, CRC)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:TOBIN
Suffix:
Gender:F
Credentials:LCMHCA, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 GLENWOOD AVE APT 205
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-1480
Mailing Address - Country:US
Mailing Address - Phone:678-372-3598
Mailing Address - Fax:
Practice Address - Street 1:222 GLENWOOD AVE APT 205
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-1480
Practice Address - Country:US
Practice Address - Phone:678-372-3598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health