Healthcare Provider Details

I. General information

NPI: 1750063707
Provider Name (Legal Business Name): MADISON BARTLETT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2023
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

436 HERITAGE TERRACE LN
CARMEL IN
46032-9188
US

IV. Provider business mailing address

436 HERITAGE TERRACE LN
CARMEL IN
46032-9188
US

V. Phone/Fax

Practice location:
  • Phone: 317-417-0419
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34010558A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: