Healthcare Provider Details

I. General information

NPI: 1073104915
Provider Name (Legal Business Name): BREANN AHLMAN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2021
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 FAUNCE CORNER RD UNIT 320
DARTMOUTH MA
02747-1276
US

IV. Provider business mailing address

17 GOULD ST
NEW BEDFORD MA
02740-2219
US

V. Phone/Fax

Practice location:
  • Phone: 612-597-4649
  • Fax:
Mailing address:
  • Phone: 612-597-4649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11194
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: