Provider Demographics
NPI:1538835335
Name:MAY, STACEY (LCSW)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:MAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:
Other - Last Name:MCKIBBIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1575 DR MARTIN LUTHER KING JR ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-2295
Mailing Address - Country:US
Mailing Address - Phone:317-644-7243
Mailing Address - Fax:
Practice Address - Street 1:10 S 9TH ST STE 8
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-2631
Practice Address - Country:US
Practice Address - Phone:317-207-9694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34009387A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical