Provider Demographics
NPI:1376322982
Name:DE GALE, CARSHELL L (LGSW)
Entity Type:Individual
Prefix:MS
First Name:CARSHELL
Middle Name:L
Last Name:DE GALE
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3252 GREEN COVE PL
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-4652
Mailing Address - Country:US
Mailing Address - Phone:215-767-6370
Mailing Address - Fax:
Practice Address - Street 1:35 K ST NE BLDG 14
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4216
Practice Address - Country:US
Practice Address - Phone:202-673-6495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG200001263104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker