Provider Demographics
NPI:1609763366
Name:HEINIGER, MADISON GRACE (LSW)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:GRACE
Last Name:HEINIGER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18836 PILOT MILLS DR
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-8002
Mailing Address - Country:US
Mailing Address - Phone:765-481-5599
Mailing Address - Fax:
Practice Address - Street 1:580 E CARMEL DR STE 400
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3316
Practice Address - Country:US
Practice Address - Phone:317-564-8332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-23
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33012615A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty