Provider Demographics
NPI:1164064580
Name:STEALY, MADELINE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MADELINE
Middle Name:
Last Name:STEALY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 S 8TH ST STE 3500
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-2662
Mailing Address - Country:US
Mailing Address - Phone:317-934-2177
Mailing Address - Fax:
Practice Address - Street 1:23 S 8TH ST STE 3500
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-2662
Practice Address - Country:US
Practice Address - Phone:317-934-2177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35001959A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist