Active NPI
Dale Dicker, MED LCSW
- Professional Counselor
- St Louis, MO
National Provider Identifier
1053475111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 000956
- Practice address
- 11715 Administration Dr
Ste 101
St Louis, MO 63146 - Phone
- (314) 993-8123
- Fax
- (314) 993-8123
- NPI assigned
- Dec 21, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 000956 | MO | Primary |
| Clinical Social Worker | 1041C0700X | 002320 | MO |
Addresses
Primary practice location
11715 Administration Dr
Ste 101
St Louis, MO 63146
Mailing address
11715 Administration Dr
Ste 101
St Louis, MO 63146
Phone (314) 993-8123
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000956 | MO | MD | Professional Counselor |
| 002320 | MO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1053475111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11715 ADMINISTRATION DR",
"address_2": "STE 101",
"city": "ST LOUIS",
"state": "MO",
"postal_code": "63146",
"telephone_number": "314-993-8123",
"fax_number": "314-993-8123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11715 ADMINISTRATION DR",
"address_2": "STE 101",
"city": "ST LOUIS",
"state": "MO",
"postal_code": "63146",
"telephone_number": "314-993-8123",
"fax_number": "314-993-8123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKER",
"first_name": "DALE",
"name_prefix": "Mr.",
"credential": "MED LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-21",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "000956",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "002320",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.