Provider Demographics
NPI:1790169480
Name:FLATTERY, MADISON (MSW, LMSW, LISW)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:FLATTERY
Suffix:
Gender:F
Credentials:MSW, LMSW, LISW
Other - Prefix:MRS
Other - First Name:MADISON
Other - Middle Name:
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW, LMSW
Mailing Address - Street 1:706 8TH ST SW
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:IA
Mailing Address - Zip Code:50009-2303
Mailing Address - Country:US
Mailing Address - Phone:515-809-0848
Mailing Address - Fax:
Practice Address - Street 1:706 8TH ST SW
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:IA
Practice Address - Zip Code:50009-2303
Practice Address - Country:US
Practice Address - Phone:515-809-0848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA077994104100000X, 1041C0700X
IA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker