Provider Demographics
NPI:1417794702
Name:DAHLHEIMER, AMBER (LICSW)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:DAHLHEIMER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 GENES RD SE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-5183
Mailing Address - Country:US
Mailing Address - Phone:971-313-4310
Mailing Address - Fax:
Practice Address - Street 1:3200 LABORE RD STE 104
Practice Address - Street 2:
Practice Address - City:VADNAIS HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55110-5186
Practice Address - Country:US
Practice Address - Phone:651-392-7956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-12
Last Update Date:2024-12-24
Deactivation Date:2024-07-15
Deactivation Code:
Reactivation Date:2024-12-24
Provider Licenses
StateLicense IDTaxonomies
MN275501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical