Provider Demographics
NPI:1215245949
Name:BADGELY, HEIDI E (LCSW)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:E
Last Name:BADGELY
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 1:8400 LOUISIANA ST
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6385
Mailing Address - Country:US
Mailing Address - Phone:219-757-1939
Mailing Address - Fax:219-757-1950
Practice Address - Street 1:1409 E 84TH PL
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6451
Practice Address - Country:US
Practice Address - Phone:219-757-1939
Practice Address - Fax:219-757-1950
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004191A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000706958OtherANTHEM BC/BS
INM400042551Medicare PIN