Individual provider Active NPI

Jennifer A Dale, LPC-A

  • Counselor
  • Columbia, SC
National Provider Identifier
1902361454
Registry record updated Feb 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
7040 Issued in SC
Practice address
1911 Gadsden St
Columbia, SC 29201-6400
Phone
(803) 254-9767
NPI assigned
Feb 8, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 7040 SC Primary

Addresses

Primary practice location

1911 Gadsden St
Columbia, SC 29201-6400

Mailing address

112 Ironcrest Way
Columbia, SC 29212-0607
Phone (803) 873-1192

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1549584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549584000000",
    "number": "1902361454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 IRONCREST WAY",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292120607",
            "telephone_number": "803-873-1192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 GADSDEN ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292016400",
            "telephone_number": "803-254-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "LPC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-08",
        "last_updated": "2019-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "SC",
            "license": "7040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2019; 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.