Healthcare Provider Details

I. General information

NPI: 1710660733
Provider Name (Legal Business Name): DALE W MC GEE LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2023
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3203 411TH ST E
MYAKKA CITY FL
34251-2246
US

IV. Provider business mailing address

3203 411TH ST E
MYAKKA CITY FL
34251-2246
US

V. Phone/Fax

Practice location:
  • Phone: 207-546-2712
  • Fax:
Mailing address:
  • Phone: 207-546-2712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC2184
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: