Healthcare Provider Details

I. General information

NPI: 1093205015
Provider Name (Legal Business Name): ELIZABETH ANNE DASH LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELIZABETH ANNE BOESEL

II. Dates (important events)

Enumeration Date: 05/15/2018
Last Update Date: 09/05/2023
Certification Date: 09/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 MURVIHILL RD
VALPARAISO IN
46383-5960
US

IV. Provider business mailing address

2322 CHICAGO ST APT 203
VALPARAISO IN
46383-5317
US

V. Phone/Fax

Practice location:
  • Phone: 219-286-3907
  • Fax:
Mailing address:
  • Phone: 219-616-9996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39002845A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number39002845A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: