| Doctor Name: | MR. MATTHEW JOSEPH DAHLSTEN |
| NPI Number: | 1114170826 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPCC |
| License Number: | 0143431 |
| Business Practice Address: | 1720 E. 32nd St Silver City, NM - 88061 |
| Business Phone Number: | 5753884412 |
| Business Fax Number: | 5753138236 |
| Mailing Address: | 530 Demoss St, LORDSBURG |
| State: | NM |
| Postal Code: | 880452618 |
| Phone Number: | 5755428384 |
| Fax Number: | 5755422388 |
| NPI Enumeration Date: | 10/24/2008 |
| NPI Last Update Date: | 07/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 0143431 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |