Provider Demographics
NPI:1336298934
Name:DAHLBERG, KATHERINE L (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:L
Last Name:DAHLBERG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3235 VOLLMER RD
Mailing Address - Street 2:SUITE 119
Mailing Address - City:FLOSSMOOR
Mailing Address - State:IL
Mailing Address - Zip Code:60422-2013
Mailing Address - Country:US
Mailing Address - Phone:708-754-8815
Mailing Address - Fax:708-798-1315
Practice Address - Street 1:3235 VOLLMER RD
Practice Address - Street 2:SUITE 119
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-2013
Practice Address - Country:US
Practice Address - Phone:708-754-8815
Practice Address - Fax:708-798-1315
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker