Provider Demographics
NPI:1689698995
Name:GREEDY, DALE CLIFFORD (LMSW, CPC)
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:CLIFFORD
Last Name:GREEDY
Suffix:
Gender:M
Credentials:LMSW, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 FLETCHER ST
Mailing Address - Street 2:PO 254
Mailing Address - City:SIDNEY
Mailing Address - State:IA
Mailing Address - Zip Code:51652-3025
Mailing Address - Country:US
Mailing Address - Phone:712-374-3004
Mailing Address - Fax:
Practice Address - Street 1:100 E BROADWAY STE 200
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-4409
Practice Address - Country:US
Practice Address - Phone:712-323-4478
Practice Address - Fax:712-323-4188
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20184101YA0400X
IA03080101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health