Healthcare Provider Details

I. General information

NPI: 1164879763
Provider Name (Legal Business Name): FRANCIS DAHLMEYER III LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2016
Last Update Date: 03/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 CEDAR ST
NEW BRITAIN CT
06052-1301
US

IV. Provider business mailing address

100 GRAND ST STE E119
NEW BRITAIN CT
06052-2016
US

V. Phone/Fax

Practice location:
  • Phone: 860-224-5804
  • Fax:
Mailing address:
  • Phone: 860-224-5900
  • Fax: 860-224-5740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number010414
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: