Provider Demographics
NPI:1366524399
Name:DAHL, SHEILA BARTLETT (MA LCMHC)
Entity type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:BARTLETT
Last Name:DAHL
Suffix:
Gender:F
Credentials:MA LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 NORTHWEST BLVD
Mailing Address - Street 2:FOUNTAIN PSYCHOLOGICAL ASSOCIATES
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063
Mailing Address - Country:US
Mailing Address - Phone:603-881-9311
Mailing Address - Fax:603-595-7772
Practice Address - Street 1:29 NORTHWEST BLVD
Practice Address - Street 2:SLATOFF AND WARD PSYCHOLOGICAL
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063
Practice Address - Country:US
Practice Address - Phone:603-881-9311
Practice Address - Fax:603-595-7772
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH115101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30423786Medicaid