Provider Demographics
NPI:1518690817
Name:VERDESCA, MADELINE CLAIR (MA)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:CLAIR
Last Name:VERDESCA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:MADELINE
Other - Middle Name:CLAIR
Other - Last Name:BAXTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:3102 MORNINGSIDE PARK CT
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-2900
Mailing Address - Country:US
Mailing Address - Phone:425-275-3895
Mailing Address - Fax:
Practice Address - Street 1:1025 POWERS PL
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-8356
Practice Address - Country:US
Practice Address - Phone:425-275-3895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-05
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC015761101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional