Vander J Dale Jr, LMSW, LCAC, CATC-IV, is a
Social Worker based in Long Beach, California. Vander J Dale Jr is licensed to practice in Tennessee (license number LSW0000008307) and his current practice location is
2090 River Avenue, Long Beach, California. He can be reached at his office (for appointments etc.) via phone at
(562) 826-8470.
NPI number for Vander J Dale Jr is 1619241601 and his current mailing address is 2090 River Avenue, Long Beach, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1619241601.
Healthcare Provider's Profile
| Full Name | Vander J Dale Jr |
|---|
| Gender | Male |
|---|
| Speciality | Social Worker |
|---|
| Location | 2090 River Avenue, Long Beach, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1619241601
- Provider Enumeration Date: 03/08/2012
- Last Update Date: 03/08/2012
Medical Identifiers
Medical identifiers for Vander J Dale Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1619241601 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | 87001320A (Indiana) | Secondary |
| 104100000X | Social Worker | LSW0000008307 (Tennessee) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Vander J Dale Jr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Vander J Dale Jr, LMSW, LCAC, CATC-IV,
2090 River Avenue,
Long Beach, CA 90810
Ph: (562) 826-8470 | Vander J Dale Jr, LMSW, LCAC, CATC-IV,
2090 River Avenue,
Long Beach, CA 90810
Ph: (562) 826-8470 |
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