Healthcare Provider Details

I. General information

NPI: 1396013926
Provider Name (Legal Business Name): DALE A ENGLISH MS CAS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2011
Last Update Date: 12/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 MARKET ST COMMUNITY COUSELING
BANGOR PA
18013-1901
US

IV. Provider business mailing address

RR 1 BOX 819
DINGMANS FERRY PA
18328-9753
US

V. Phone/Fax

Practice location:
  • Phone: 610-588-9109
  • Fax:
Mailing address:
  • Phone: 570-242-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: