Provider Demographics
NPI:1750081691
Name:DAHLGREN, SARA
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:DAHLGREN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5549 460TH LN
Mailing Address - Street 2:
Mailing Address - City:HAY SPRINGS
Mailing Address - State:NE
Mailing Address - Zip Code:69347-6102
Mailing Address - Country:US
Mailing Address - Phone:308-430-0209
Mailing Address - Fax:775-667-6079
Practice Address - Street 1:5549 460TH LN
Practice Address - Street 2:
Practice Address - City:HAY SPRINGS
Practice Address - State:NE
Practice Address - Zip Code:69347-6102
Practice Address - Country:US
Practice Address - Phone:308-430-0209
Practice Address - Fax:775-667-6079
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-08
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7836104100000X
NE13327101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker