Provider Demographics
NPI:1871471854
Name:JERRY, MADILYN
Entity type:Individual
Prefix:
First Name:MADILYN
Middle Name:
Last Name:JERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3546 HOFF LN
Mailing Address - Street 2:
Mailing Address - City:TODDVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52341-9727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3412 CENTER POINT RD NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5575
Practice Address - Country:US
Practice Address - Phone:319-382-8660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical