Provider Demographics
NPI:1447962550
Name:VANORE, MADISON (LSW)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:VANORE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:MADISON
Other - Middle Name:
Other - Last Name:KEARNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:57 HADDONFIELD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-4807
Mailing Address - Country:US
Mailing Address - Phone:609-889-8100
Mailing Address - Fax:
Practice Address - Street 1:57 HADDONFIELD RD STE 100
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-4807
Practice Address - Country:US
Practice Address - Phone:609-889-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06808900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health