Provider Demographics
NPI:1760866552
Name:CASEY LEWIS, DANA T (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:T
Last Name:CASEY LEWIS
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:T
Other - Last Name:CASEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LSW
Mailing Address - Street 1:1111 E 54TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-3580
Mailing Address - Country:US
Mailing Address - Phone:317-908-6063
Mailing Address - Fax:317-896-0360
Practice Address - Street 1:1111 E 54TH ST STE 101
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-3580
Practice Address - Country:US
Practice Address - Phone:317-908-6063
Practice Address - Fax:317-896-0360
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33006078A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker