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General NPI Number Information
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NPI Number | 1972799971
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Entity Type | Individual
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Provider Name | STACY D VEACH MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/24/2007
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Last Update Date | 09/24/2007
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Provider Practice Location Address
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Address Line | 8820 S MERIDIAN ST SUITE 225
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City | INDIANAPOLIS
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State | IN
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Zip | 46217-6056
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Country | US
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Telephone | 317-865-6922
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Fax | 317-865-6930
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Provider Business Mailing Address
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Address Line | 250 N SHADELAND AVE 2ND FL
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-4959
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Country | US
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Telephone | 317-962-4792
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Fax | 317-962-8646
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34004112A
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License Number State | IN
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