Vandyke, Dale F.

Vandyke, Dale F. is an individual health care provider with primary practice located at 4848 S 76Th St Suite 201, Greenfield WI 53220-4361. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Vandyke, Dale F. can be contacted via phone (414) 325-7741.

Contact Information

Primary practice address
4848 S 76Th St Suite 201 Greenfield WI 53220-4361
Phone: (414) 325-7741
Fax: (414) 325-7753
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 12701 Wisconsin
Behavioral Health & Social Service Providers / Clinical 1041C0700X 2154-123 Wisconsin

Profile Details

NPI number 1487703625
LBN Legal business name Vandyke, Dale F.
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487703625 NPPES
Wisconsin MEDICAID 39585200

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