Provider Demographics
NPI:1841044815
Name:ENGELS, MADISON LEIGH (LCSW)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:LEIGH
Last Name:ENGELS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17010 OLD COVINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-5232
Mailing Address - Country:US
Mailing Address - Phone:985-265-7244
Mailing Address - Fax:
Practice Address - Street 1:17010 OLD COVINGTON HWY
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-5232
Practice Address - Country:US
Practice Address - Phone:985-265-7244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-15
Last Update Date:2024-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
LA16984104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical