Provider Demographics
NPI:1649314378
Name:DALE, ANNE MARIE THERESE (PHD LMHP CPC LIMHP)
Entity type:Individual
Prefix:MS
First Name:ANNE MARIE
Middle Name:THERESE
Last Name:DALE
Suffix:
Gender:F
Credentials:PHD LMHP CPC LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22
Mailing Address - Street 2:211 W CEDAR
Mailing Address - City:PLEASANTON
Mailing Address - State:NE
Mailing Address - Zip Code:68866
Mailing Address - Country:US
Mailing Address - Phone:308-236-8987
Mailing Address - Fax:
Practice Address - Street 1:3811 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-8173
Practice Address - Country:US
Practice Address - Phone:308-236-8987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE237101YM0800X
NE624101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health