Provider Demographics
NPI:1144043597
Name:DAHLIN, MEGHAN (LAC)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:DAHLIN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1187 MAIN AVE STE 3F
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-2252
Mailing Address - Country:US
Mailing Address - Phone:855-453-6611
Mailing Address - Fax:
Practice Address - Street 1:154 AVENUE E APT A203
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3563
Practice Address - Country:US
Practice Address - Phone:315-708-7799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00772500101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor