Provider Demographics
NPI:1255067641
Name:DALE, CHANEL LYNN (LMFT, LCPC, BAPS)
Entity type:Individual
Prefix:PROF
First Name:CHANEL
Middle Name:LYNN
Last Name:DALE
Suffix:
Gender:F
Credentials:LMFT, LCPC, BAPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 N LA BREA AVE
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90302-1218
Mailing Address - Country:US
Mailing Address - Phone:310-849-9202
Mailing Address - Fax:562-428-3930
Practice Address - Street 1:1401 N LA BREA AVE
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90302-1218
Practice Address - Country:US
Practice Address - Phone:310-849-9202
Practice Address - Fax:562-428-3930
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health