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Tyleeta J Madison, CDCA
Counselor in Lorain, Ohio
NPI 1164065256

Tyleeta J Madison is a Counselor based in Lorain, OH. Tyleeta J Madison practices in Lorain, OH and has the professional credentials of CDCA. The NPI Number for Tyleeta J Madison is 1164065256 and holds a License No. CDCA.171102 (Ohio).

The current practice location address for Tyleeta J Madison is 2115 W Park Dr, Lorain, OH and can be reached out via phone at 440-989-4900 and via fax at 440-282-4779.

Location: 2115 W Park Dr, Lorain, OH, 44053-1138
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1164065256
Provider Name
Tyleeta J Madison
Credential
CDCA
Provider Entity Type
Individual
Gender
Female
Address
2115 W Park Dr, Lorain, OH, 44053-1138
Phone Number
440-989-4900
Fax Number
440-282-4779
Provider Enumeration Date
10/22/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
CDCA.171102 01 OH LICENSE
institution
Provider Business Practice Location Address Details
Address
2115 W Park Dr
City
Lorain
State
Ohio
Zip
44053-1138
Phone Number
440-989-4900
Fax Number
440-282-4779
person
Provider Business Mailing Address Details
Address
2115 W Park Dr
City
Lorain
State
Ohio
Zip
44053-1138
Phone Number
440-989-4900
Fax Number
440-282-4779
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
CDCA.171102 (Ohio)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
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