Provider Demographics
NPI:1033943485
Name:NOHREN, MADISON LEA (LMSW)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:LEA
Last Name:NOHREN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 LITTLE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:PARK HILLS
Mailing Address - State:MO
Mailing Address - Zip Code:63601-9307
Mailing Address - Country:US
Mailing Address - Phone:636-535-5994
Mailing Address - Fax:
Practice Address - Street 1:10820 SUNSET OFFICE DR STE 220
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127-1030
Practice Address - Country:US
Practice Address - Phone:314-252-8949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024031517104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker