Healthcare Provider Details

I. General information

NPI: 1639095615
Provider Name (Legal Business Name): JESSICA DAHM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

257 W UWCHLAN AVE
DOWNINGTOWN PA
19335-3587
US

IV. Provider business mailing address

257 W UWCHLAN AVE
DOWNINGTOWN PA
19335-3587
US

V. Phone/Fax

Practice location:
  • Phone: 484-321-3259
  • Fax:
Mailing address:
  • Phone: 484-321-3259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: