Active NPI
Stephen Dahl
- Clinical Social Worker
- Chaska, MN
National Provider Identifier
1669925228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1356
- Practice address
- 111 Hundertmark Rd Ste 205N
Chaska, MN 55318-1586 - Phone
- (952) 903-1350
- NPI assigned
- Aug 1, 2016
- Sex
- Male
- 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 Social Worker | 1041C0700X | 1356 | MN | Primary |
Addresses
Primary practice location
111 Hundertmark Rd Ste 205N
Chaska, MN 55318-1586
Mailing address
111 Hundertmark Rd Ste 205N
Chaska, MN 55318-1586
Phone (952) 903-1350
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1356 | MN | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470009600000",
"number": "1669925228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 HUNDERTMARK RD STE 205N",
"city": "CHASKA",
"state": "MN",
"postal_code": "553181586",
"telephone_number": "952-903-1350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 HUNDERTMARK RD STE 205N",
"city": "CHASKA",
"state": "MN",
"postal_code": "553181586",
"telephone_number": "952-903-1350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAHL",
"first_name": "STEPHEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-01",
"last_updated": "2016-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "1356",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chaska, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.