Active NPI
Milfred Douglas Dale, PHD
- Psychologist
- Topeka, KS
National Provider Identifier
1003991738
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- KS706
- Practice address
- 2201 SW 29TH Street
Topeka, KS 66611 - Phone
- (785) 267-0025
- Fax
- (785) 266-6546
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | KS706 | KY | Primary |
Addresses
Primary practice location
2201 SW 29TH Street
Topeka, KS 66611
Mailing address
2201 SW 29TH Street
Topeka, KS 66611
Phone (785) 267-0025
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 043057 | Other | KS | BC/BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 706 | KS | MD | Addiction (Substance Use Disorder) Counselor |
| KS706 | KY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003991738",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2201 SW 29TH STREET",
"city": "TOPEKA",
"state": "KS",
"postal_code": "66611",
"telephone_number": "785-267-0025",
"fax_number": "785-266-6546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2201 SW 29TH STREET",
"city": "TOPEKA",
"state": "KS",
"postal_code": "66611",
"telephone_number": "785-267-0025",
"fax_number": "785-266-6546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALE",
"first_name": "MILFRED",
"middle_name": "DOUGLAS",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "KY",
"license": "KS706",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "043057",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Topeka, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.