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NPI Code Detail

MEDICARE: STACY ALLENDER LCSW

MEDICARE: STACY ALLENDER LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker
21041C0700XClinical Social Worker34008554AIN

General Provider Information

NPI Number : 1407303530
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACY ALLENDER LCSW
Provider Business Mailing Address
First Line : 1160 E SAINT CLAIR ST
Second Line :
City : VINCENNES
State : IN
Zip : 47591-4853
Country : US
Telephone Number : 812-885-8763
Fax Number : 812-885-8499
Provider Business Practice Location Address
First Line : 300 N 1ST ST
Second Line :
City : VINCENNES
State : IN
Zip : 47591-1252
Country : US
Telephone Number : 812-885-2718
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2016
Last Update Date : 06/21/2023

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Directions to “ STACY ALLENDER LCSW” Practice Location

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