Provider Demographics
NPI:1265773667
Name:DABUL, STACEY (LCSW, LCADC)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:DABUL
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:MISS
Other - First Name:STACEY
Other - Middle Name:
Other - Last Name:ZELENETZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:285 DURHAM AVE
Mailing Address - Street 2:BLDG. #6, SUITE 2A
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-2546
Mailing Address - Country:US
Mailing Address - Phone:908-548-8533
Mailing Address - Fax:908-548-8532
Practice Address - Street 1:285 DURHAM AVE
Practice Address - Street 2:BLDG. #6, SUITE 2A
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-2546
Practice Address - Country:US
Practice Address - Phone:908-548-8533
Practice Address - Fax:908-548-8532
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-09
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00111600101YA0400X
NJ44SC049574001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)