Provider Demographics
NPI:1629011259
Name:MASSEY, DALLAS ANN (LMHP, LADC)
Entity Type:Individual
Prefix:MS
First Name:DALLAS
Middle Name:ANN
Last Name:MASSEY
Suffix:
Gender:F
Credentials:LMHP, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-0688
Mailing Address - Country:US
Mailing Address - Phone:308-632-8236
Mailing Address - Fax:308-635-3084
Practice Address - Street 1:1821 1ST AVE
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-2404
Practice Address - Country:US
Practice Address - Phone:308-632-8236
Practice Address - Fax:308-635-3084
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE104101YA0400X
NE1578101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health