Provider Demographics
NPI:1073012217
Name:DALE & ASSOCIATES
Entity Type:Organization
Organization Name:DALE & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPIETOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:DALE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:573-803-3137
Mailing Address - Street 1:2846 PROFESSIONAL CT
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-5035
Mailing Address - Country:US
Mailing Address - Phone:573-803-3137
Mailing Address - Fax:573-803-3137
Practice Address - Street 1:2846 PROFESSIONAL CT
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-5035
Practice Address - Country:US
Practice Address - Phone:573-803-3137
Practice Address - Fax:573-803-3137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-02
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013011401101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1417391129Medicaid
MO1184922189Medicaid