Healthcare Provider Details

I. General information

NPI: 1922017573
Provider Name (Legal Business Name): BRIAN CURTIS MADINGER MA, LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 10/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 E MAIN ST
CARMEL IN
46032-1774
US

IV. Provider business mailing address

30 E MAIN ST
CARMEL IN
46032-1774
US

V. Phone/Fax

Practice location:
  • Phone: 317-580-4099
  • Fax: 317-245-2456
Mailing address:
  • Phone: 317-580-4099
  • Fax: 317-245-2456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number646
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number35001484A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: