Healthcare Provider Details

I. General information

NPI: 1386186765
Provider Name (Legal Business Name): SHOSHANA DAHAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2016
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 W OAKLAND PARK BLVD FL 3
LAUDERDALE LAKES FL
33313-7500
US

IV. Provider business mailing address

2300 NW 89TH PL FL 3
DORAL FL
33172-2431
US

V. Phone/Fax

Practice location:
  • Phone: 954-327-4060
  • Fax:
Mailing address:
  • Phone: 305-398-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW23856
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: