Provider Demographics
NPI:1487525978
Name:DALE, AMBER DAWN (LSW)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:DAWN
Last Name:DALE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 FLETCHER ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46016-4425
Mailing Address - Country:US
Mailing Address - Phone:765-610-4706
Mailing Address - Fax:
Practice Address - Street 1:1331 W 35TH ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46953-3442
Practice Address - Country:US
Practice Address - Phone:765-233-2355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33011925A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker