Provider Demographics
NPI:1700956224
Name:GARSON, DALE SPEAR (LCSW)
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:SPEAR
Last Name:GARSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 ANDORRA HILL RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444-1705
Mailing Address - Country:US
Mailing Address - Phone:610-329-9897
Mailing Address - Fax:610-832-5332
Practice Address - Street 1:5 ANDORRA HILL RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE HILL
Practice Address - State:PA
Practice Address - Zip Code:19444-1705
Practice Address - Country:US
Practice Address - Phone:610-329-9897
Practice Address - Fax:610-832-5332
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0150821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA098454Medicare ID - Type UnspecifiedCLINICAL SOCIAL WORKER