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General NPI Number Information
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NPI Number | 1922319540
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Entity Type | Individual
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Provider Name | ANGELA K MADISON LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/29/2010
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Last Update Date | 01/13/2017
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Provider Practice Location Address
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Address Line | 1530 N COMMERCE WEST DR
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City | GREENSBURG
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State | IN
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Zip | 47240-3205
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Country | US
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Telephone | 812-663-7057
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Fax | 812-378-8367
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Provider Business Mailing Address
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Address Line | 645 S ROGERS ST
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City | BLOOMINGTON
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State | IN
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Zip | 47403-2353
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Country | US
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Telephone | 800-344-8802
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Fax | 812-378-8367
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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