Provider Demographics
NPI:1407916364
Name:DAHL, LAUREN BETH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:BETH
Last Name:DAHL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LAUREN
Other - Middle Name:BETH
Other - Last Name:PENN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3000 NE STUCKI AVE STE 230H
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-7107
Mailing Address - Country:US
Mailing Address - Phone:503-352-7806
Mailing Address - Fax:503-690-0678
Practice Address - Street 1:3000 NE STUCKI AVE STE 230H
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-7107
Practice Address - Country:US
Practice Address - Phone:503-352-7806
Practice Address - Fax:503-690-0678
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL27161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical