Individual provider Active NPI

Dale F. Vandyke, LCSW

  • Clinical Social Worker
  • Greenfield, WI
National Provider Identifier
1487703625
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2154-123 Issued in WI
Practice address
4848 S 76TH St
Suite 201
Greenfield, WI 53220-4361
Phone
(414) 325-7741
Fax
(414) 325-7753
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 12701 WI
Clinical Social Worker 1041C0700X 2154-123 WI Primary

Addresses

Primary practice location

4848 S 76TH St
Suite 201
Greenfield, WI 53220-4361

Mailing address

4848 S 76TH St
Suite 201
Greenfield, WI 53220-4361
Phone (414) 325-7741

Other identifiers 1

IdentifierTypeStateIssuer
39585200MedicaidWI

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

State licenses

LicenseStateTypeSpecialty
12701WIMDAddiction (Substance Use Disorder) Counselor
2154-123WIMDClinical Social Worker
2154WIMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Child & Family Therapeutic Systems S.C. Addiction (Substance Use Disorder) PastSince Jan 1, 1998 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1487703625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4848 S 76TH ST",
            "address_2": "SUITE 201",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204361",
            "telephone_number": "414-325-7741",
            "fax_number": "414-325-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4848 S 76TH ST",
            "address_2": "SUITE 201",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204361",
            "telephone_number": "414-325-7741",
            "fax_number": "414-325-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDYKE",
        "first_name": "DALE",
        "middle_name": "F.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "12701",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "2154-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39585200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

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.

Verify at the official NPI Registry.