Amy Dahl, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2336 Issued in MN

Practice address

25282 Hazelwood Dr
Nisswa, MN 56468-2797

Phone

(218) 820-7671

NPI assigned

Jul 11, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Jennifer Vaughn Therapy Services LLC

  • Community/Behavioral Health Agency
  • Nisswa, MN
  • NPI 1609290691

  Marriage & Family Therapist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1625961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625961600000",
    "number": "1629640636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25282 HAZELWOOD DR",
            "city": "NISSWA",
            "state": "MN",
            "postal_code": "564682797",
            "telephone_number": "218-820-7671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25282 HAZELWOOD DR",
            "city": "NISSWA",
            "state": "MN",
            "postal_code": "564682797",
            "telephone_number": "218-820-7671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4682 Wilderness Ct # 103",
            "address_purpose": "LOCATION",
            "city": "Brainerd",
            "state": "MN",
            "postal_code": "564012834",
            "country_code": "US",
            "telephone_number": "218-820-7671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAHL",
        "first_name": "AMY",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-11",
        "last_updated": "2021-07-11",
        "certification_date": "2021-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Bridgwater, M.D.
• Carlyn Becker Therapy Services
• Beatrice Marie-Rachelle Comty-Charnock, LMFT, LADC
• Shana Crouse
• Cuyuna Regional Medical Center
• Daniel Marquardsen Therapy L.L.C
• Michelle Glassmann
• Dennis Dean Hins, RPH
• Jennifer Vaughn Therapy Services LLC
• Craig Brian Johnson, DDS

• Marriage & Family Therapist in Nisswa, MN
• Providers in Nisswa, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.