Malinda Ann Dale, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY002619 Issued in GA

Practice address

506 N Jackson St
The Renaissance Centre
Albany, GA 31701-2308

Phone

(229) 889-7200

Fax

(229) 889-7393

NPI assigned

Nov 16, 2005

Last updated

Jun 28, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA, MO2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St. Louis Behavioral Medicine Institute IncGroup PAC ID 3173428638, 67 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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

• St. Louis Behavioral Medicine Institute Inc

  • Psychologist
  • Saint Louis, MO
  • NPI 1487732335
  Medicare reassignment Care Compare group NPD
• The Renaissance Centre, Inc.

  • Psychologist
  • Albany, GA
  • NPI 1104970193
  Medicare reassignment NPD
• St. Louis Behavioral Medicine Institute Inc

  dba St Louis Behavioral Medicine Institute

  • Mental Health Counselor
  • Fairview Heights, IL
  • NPI 1952169179
  NPD

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309219200000",
    "number": "1629050570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 FLOWING WELL RD",
            "city": "LEESBURG",
            "state": "GA",
            "postal_code": "317633126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 N JACKSON ST",
            "address_2": "THE RENAISSANCE CENTRE",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317012308",
            "telephone_number": "229-889-7200",
            "fax_number": "229-889-7393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE",
        "first_name": "MALINDA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-16",
        "last_updated": "2011-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY002619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000966985A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rashaad Culver, RPH
• James Cade Cummings, BCBA
• Starnika Cunningham
• Catherine Allison Curington, PHARMD
• Desiree Dalcherone, DPM
• Nathan J. Dallas, D.M.D.
• Sharon Dancer
• Donald Houston Daniel, P.T.
• Jaclyn Pieper Daniel, PHARM. D
• Shelby Daniel

• Psychologist in Albany, GA
• Providers in Albany, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.