Provider Demographics
NPI:1003309030
Name:DALE, IEISHA S (LMFT)
Entity Type:Individual
Prefix:
First Name:IEISHA
Middle Name:S
Last Name:DALE
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 1:5225 CONNECTICUT AVE NW STE 705
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-1813
Mailing Address - Country:US
Mailing Address - Phone:240-863-2618
Mailing Address - Fax:
Practice Address - Street 1:5225 CONNECTICUT AVE NW STE 705
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-1813
Practice Address - Country:US
Practice Address - Phone:240-863-2618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist