MEDICARE: MISS SHOSHANA DAHAN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW23856	FL

General Provider Information

NPI Number	:	1386186765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS SHOSHANA DAHAN LCSW

Provider Business Mailing Address
First Line	:	2300 NW 89TH PL FL 3
Second Line	:
City	:	DORAL
State	:	FL
Zip	:	33172-2431
Country	:	US
Telephone Number	:	305-398-6100
Fax Number	:

Provider Business Practice Location Address
First Line	:	4900 W OAKLAND PARK BLVD FL 3
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33313-7500
Country	:	US
Telephone Number	:	954-327-4060
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2016
Last Update Date	:	12/09/2025

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