Active NPI
Dale Daywalt
- Mental Health Counselor
- Philadelphia, PA
National Provider Identifier
1942767892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 9815 Roosevelt Blvd Ste B
Philadelphia, PA 19114-1035 - Phone
- (610) 644-6464
- NPI assigned
- Feb 27, 2019
- Last updated
- Feb 27, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
9815 Roosevelt Blvd Ste B
Philadelphia, PA 19114-1035
Mailing address
680 American Ave
King of Prussia, PA 19406-4023
Phone (610) 644-6464
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life Management Inc | Mental Health | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551225600000",
"number": "1942767892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "680 AMERICAN AVE",
"city": "KING OF PRUSSIA",
"state": "PA",
"postal_code": "194064023",
"telephone_number": "610-644-6464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9815 ROOSEVELT BLVD STE B",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191141035",
"telephone_number": "610-644-6464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAYWALT",
"first_name": "DALE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-02-27",
"last_updated": "2019-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.