Provider Demographics
NPI:1679701478
Name:DAHLSTRAND, JOSEPH (LCSW)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:DAHLSTRAND
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2185 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-4747
Mailing Address - Country:US
Mailing Address - Phone:814-464-8311
Mailing Address - Fax:814-464-8462
Practice Address - Street 1:2185 W 8TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-4747
Practice Address - Country:US
Practice Address - Phone:814-464-8311
Practice Address - Fax:814-464-8462
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0160381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical