Provider Demographics
NPI:1831669746
Name:DACEY, STEPHEN (LMSW)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:DACEY
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 ANGELL AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-5002
Mailing Address - Country:US
Mailing Address - Phone:603-667-1603
Mailing Address - Fax:
Practice Address - Street 1:57 EXCHANGE ST STE 203
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-5000
Practice Address - Country:US
Practice Address - Phone:603-667-1603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-04
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC206951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical