Active NPI
Lynda Diane Dahlke, PHD
- Clinical Psychologist
- Waukesha, WI
National Provider Identifier
1457535676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1825-57
- Practice address
- 1501 Airport Rd
Waukesha, WI 53188-2461 - Phone
- (262) 896-8252
- NPI assigned
- Dec 24, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1825-57 | WI | Primary |
Addresses
Primary practice location
1501 Airport Rd
Waukesha, WI 53188-2461
Mailing address
500 Riverview Ave
Waukesha, WI 53188-3632
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1825-057 | Other | WI | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1825-57 | WI | MD | Clinical Psychologist |
| 1825 | WI | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thousand Mile Journey LLC | Past | Accepting new patients | |
| Stress Management & Mental Health Clinics Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301356800000",
"number": "1457535676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 RIVERVIEW AVE",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531883632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 AIRPORT RD",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531882461",
"telephone_number": "262-896-8252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAHLKE",
"first_name": "LYNDA",
"middle_name": "DIANE",
"name_prefix": "Prof.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-24",
"last_updated": "2011-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WI",
"license": "1825-57",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "1825-057",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waukesha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.