Individual ProviderLance MadowCounselorBehavioral Health & Social Service ProvidersPractice Address3495 Piedmont Rd NE, Building 10, Suite 100, Atlanta, GA 30305(770) 758-7817(727) 916-2257PECOS EnrollmentBased on the most recent information from CMS, provider Lance Madow does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:47 AM.Profile DetailsProvider ID1023797693Provider TypeIndividualFull NameMadow, LanceGenderMaleSole ProprietorNoEnumeration Date7/12/2023Last Updated7/12/2023Contact InformationPractice LocationPractice Address3495 Piedmont Rd NE, Building 10, Suite 100, Atlanta, GA 30305Phone(770) 758-7817FaxUnlisted FaxMailing LocationMailing Address245 E Trinity Pl Unit 1423, Decatur, GA 30030-3493Phone(727) 916-2257FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer