Healthcare Provider Details

I. General information

NPI: 1629504048
Provider Name (Legal Business Name): INGRID J DALE-ALI, MSW, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2017
Last Update Date: 05/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4920 YORK ROAD SUITE 2BB
DOYLESTOWN PA
18902-1115
US

IV. Provider business mailing address

1003 STEVIE LN
PENNSBURG PA
18073-2335
US

V. Phone/Fax

Practice location:
  • Phone: 215-872-6954
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW014793
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: INGRID DALE-ALI
Title or Position: OWNER
Credential: MSW, LCSW
Phone: 215-872-6954