Provider Demographics
NPI:1205237054
Name:DAHL, DANNA MARIE (MA, LCMFT, LCPC)
Entity type:Individual
Prefix:MRS
First Name:DANNA
Middle Name:MARIE
Last Name:DAHL
Suffix:
Gender:F
Credentials:MA, LCMFT, LCPC
Other - Prefix:MRS
Other - First Name:DANNA
Other - Middle Name:MARIE
Other - Last Name:DOUGLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11030 OAKMONT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1100
Mailing Address - Country:US
Mailing Address - Phone:913-486-5139
Mailing Address - Fax:
Practice Address - Street 1:11030 OAKMONT
Practice Address - Street 2:SUITE 200
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1100
Practice Address - Country:US
Practice Address - Phone:913-486-5139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-11
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLCPC 2326101YP2500X
KSLCMFT 713106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist