Healthcare Provider Details

I. General information

NPI: 1134702459
Provider Name (Legal Business Name): MARGARET L DOLLAHAN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2021
Last Update Date: 09/26/2023
Certification Date: 09/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 S FAIR OAKS AVE APT 305
MADISON WI
53704-5836
US

IV. Provider business mailing address

122 W WASHINGTON AVE STE 630
MADISON WI
53703-2758
US

V. Phone/Fax

Practice location:
  • Phone: 815-353-1603
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2128-124
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: