Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dale Bothun, LICSW

Individual provider Clinical Social Worker · NPI 1881221174

Dale Bothun, LICSW is a Clinical Social Worker in Saint Paul, Minnesota. Licensed in Minnesota. Registered with an NPI since 2020.

Licensed in
MN
In the registry since
2020
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

570 Asbury St Ste 300
Saint Paul, MN 55104-1851
Phone: (651) 644-8515
Fax: (651) 644-3451
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 24553 (MN)

Record details

NPI number1881221174
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorNo
NPI enumeratedMarch 25, 2020
Last updated in NPPESMarch 25, 2020
Certification dateMarch 25, 2020

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