Provider Demographics
NPI:1881291763
Name:ENGLAND, DALLAS JOANN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:DALLAS
Middle Name:JOANN
Last Name:ENGLAND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DALLAS
Other - Middle Name:
Other - Last Name:HUTCHINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:950 N MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-1077
Practice Address - Country:US
Practice Address - Phone:317-963-2200
Practice Address - Fax:317-963-1621
Is Sole Proprietor?:No
Enumeration Date:2020-10-05
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33009791A104100000X
IN34010172A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300074148Medicaid
IN264431077OtherMEDICARE PTAN