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NPI Code Detail

MEDICARE: MADISON CARLSON LCSW

MEDICARE: MADISON CARLSON LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker34012911AIN

General Provider Information

NPI Number : 1487584934
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADISON CARLSON LCSW
Provider Business Mailing Address
First Line : 881 SAINT ANDREWS DR
Second Line :
City : AVON
State : IN
Zip : 46123-8994
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3171 N MERIDIAN ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46208-4784
Country : US
Telephone Number : 317-880-8491
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2026
Last Update Date : 05/19/2026

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Directions to “ MADISON CARLSON LCSW” Practice Location

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