Provider Demographics
NPI:1659310019
Name:DAHNKE, JANICE LYNN (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:LYNN
Last Name:DAHNKE
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454-1512
Mailing Address - Country:US
Mailing Address - Phone:612-273-5640
Mailing Address - Fax:612-273-5634
Practice Address - Street 1:5009 EXCELSIOR BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-3041
Practice Address - Country:US
Practice Address - Phone:952-836-1689
Practice Address - Fax:952-836-0251
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN101331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical