Provider Demographics
NPI:1710117171
Name:DANDRIDGE, DENA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DENA
Middle Name:
Last Name:DANDRIDGE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:DENA
Other - Middle Name:
Other - Last Name:DANDRIDGE-MAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 406
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444-0406
Mailing Address - Country:US
Mailing Address - Phone:610-844-4782
Mailing Address - Fax:610-941-5624
Practice Address - Street 1:111 PRESIDENTIAL BLVD
Practice Address - Street 2:SUITE 237
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1008
Practice Address - Country:US
Practice Address - Phone:610-844-4782
Practice Address - Fax:610-941-5624
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0133151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical