Provider Demographics
NPI:1679839757
Name:DAHLIN, MEGHAN NICOLE (MA LCPC LPC LAC LMHC)
Entity Type:Individual
Prefix:MS
First Name:MEGHAN
Middle Name:NICOLE
Last Name:DAHLIN
Suffix:
Gender:F
Credentials:MA LCPC LPC LAC LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6485 W INTERCHANGE LN STE 110
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-2102
Mailing Address - Country:US
Mailing Address - Phone:208-258-9107
Mailing Address - Fax:844-662-3118
Practice Address - Street 1:6485 W INTERCHANGE LN STE 110
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-2102
Practice Address - Country:US
Practice Address - Phone:208-258-9107
Practice Address - Fax:844-662-3118
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6015101Y00000X, 101YP2500X, 101YM0800X
UT10416579-6004101YM0800X
FL14000101YM0800X
ID6588101YM0800X
MI6401223910101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional