MEDICARE: MS. KATE DAHLSTEDT LMHC

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	106S00000X	Behavior Technician	002081-01	NY
2	101YM0800X	Mental Health Counselor	002081-1	NY

General Provider Information

NPI Number	:	1770714180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATE DAHLSTEDT LMHC

Provider Business Mailing Address
First Line	:	350 FAIRWAY DR STE 101
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33441-1834
Country	:	US
Telephone Number	:	877-418-2978
Fax Number	:	866-500-2186

Provider Business Practice Location Address
First Line	:	225 CEDAR HILL ST STE 200
Second Line	:
City	:	MARLBOROUGH
State	:	MA
Zip	:	01752-5900
Country	:	US
Telephone Number	:	518-727-8107
Fax Number	:

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

Provider Enumeration Date	:	08/03/2009
Last Update Date	:	02/08/2023

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