Individual provider Active NPI

Laura M Dale, L.C.S.W.

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1194837609
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C003288 Issued in NC
Practice address
220 Swinburne Rd
Raleigh, NC 27610-1834
Phone
(919) 212-7871
Fax
(919) 212-7585
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C003288 NC Primary

Addresses

Primary practice location

220 Swinburne Rd
Raleigh, NC 27610-1834

Mailing address

206 Honeysuckle LN
Cary, NC 27513-4923
Phone (919) 234-9014

Other identifiers 1

IdentifierTypeStateIssuer
6003678MedicaidNC

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
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C003288NCMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194837609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 HONEYSUCKLE LN",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275134923",
            "telephone_number": "919-234-9014",
            "fax_number": "919-212-7585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 SWINBURNE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101834",
            "telephone_number": "919-212-7871",
            "fax_number": "919-212-7585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE",
        "first_name": "LAURA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C003288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6003678",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.