Provider Demographics
NPI:1578362604
Name:HAMBURGER-WADEMAN, MADOLYN
Entity type:Individual
Prefix:
First Name:MADOLYN
Middle Name:
Last Name:HAMBURGER-WADEMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1392
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68702-1392
Mailing Address - Country:US
Mailing Address - Phone:402-371-0220
Mailing Address - Fax:
Practice Address - Street 1:2718 13TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-4917
Practice Address - Country:US
Practice Address - Phone:402-371-0220
Practice Address - Fax:402-644-4593
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-2290101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)