Provider Demographics
NPI:1740473586
Name:ROHN, MADELAINE BERGER (PHD LCSW)
Entity type:Individual
Prefix:DR
First Name:MADELAINE
Middle Name:BERGER
Last Name:ROHN
Suffix:
Gender:F
Credentials:PHD LCSW
Other - Prefix:DR
Other - First Name:MADELAINE
Other - Middle Name:BERGER
Other - Last Name:PINKUS ROHN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD LCSW
Mailing Address - Street 1:8935 N MERIDIAN
Mailing Address - Street 2:#100
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240
Mailing Address - Country:US
Mailing Address - Phone:317-253-0548
Mailing Address - Fax:317-253-0548
Practice Address - Street 1:8935 N MERIDIAN ST
Practice Address - Street 2:#100
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5379
Practice Address - Country:US
Practice Address - Phone:317-253-0548
Practice Address - Fax:317-253-0548
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34000004A1041C0700X
IN35000005A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist