Provider Demographics
NPI:1154035277
Name:ALFARO, DAHLIA (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:DAHLIA
Middle Name:
Last Name:ALFARO
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 E SAINT CHARLES RD STE 212
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-2600
Mailing Address - Country:US
Mailing Address - Phone:630-791-0118
Mailing Address - Fax:630-708-7654
Practice Address - Street 1:640 E SAINT CHARLES RD STE 212
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2600
Practice Address - Country:US
Practice Address - Phone:630-791-0118
Practice Address - Fax:630-708-7654
Is Sole Proprietor?:No
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178016166101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1831594407OtherGROUP NPI