Provider Demographics
NPI:1295544427
Name:MADSEN, KATELYN MARIE (LMHC)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:MARIE
Last Name:MADSEN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8404 SIEAR TER
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-7215
Mailing Address - Country:US
Mailing Address - Phone:317-882-5122
Mailing Address - Fax:
Practice Address - Street 1:8404 SIEAR TER
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-7215
Practice Address - Country:US
Practice Address - Phone:317-882-5122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39005247A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health