Provider Demographics
NPI:1770959363
Name:DABELOW, LACEY (LCSW)
Entity type:Individual
Prefix:
First Name:LACEY
Middle Name:
Last Name:DABELOW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LACEY
Other - Middle Name:
Other - Last Name:HOWTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1434 SHELBY ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46203-1945
Mailing Address - Country:US
Mailing Address - Phone:317-655-3200
Mailing Address - Fax:317-655-3210
Practice Address - Street 1:1434 SHELBY ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46203-1945
Practice Address - Country:US
Practice Address - Phone:317-655-3200
Practice Address - Fax:317-655-3210
Is Sole Proprietor?:No
Enumeration Date:2015-08-18
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34006140A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical