Provider Demographics
NPI:1710631429
Name:STEIN, DOROTHY M (PHD, MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:M
Last Name:STEIN
Suffix:
Gender:F
Credentials:PHD, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6310 STALLION WAY
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2858
Mailing Address - Country:US
Mailing Address - Phone:317-431-0548
Mailing Address - Fax:317-299-0274
Practice Address - Street 1:6310 STALLION WAY
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2858
Practice Address - Country:US
Practice Address - Phone:317-431-0548
Practice Address - Fax:317-299-0274
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005807A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical