Healthcare Provider Details
I. General information
NPI: 1629397476
Provider Name (Legal Business Name): MICHELE ANN MADLEY MS, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/19/2010
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6401 S US HIGHWAY 41
TERRE HAUTE IN
47802-4749
US
IV. Provider business mailing address
6401 S US HIGHWAY 41
TERRE HAUTE IN
47802-4749
US
V. Phone/Fax
- Phone: 812-299-1156
- Fax: 812-298-3291
- Phone: 812-299-1156
- Fax: 812-298-3291
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 39001169A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: