Basic Information
| Provider Information | |||||||||
| NPI: | 1538107081 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STILLWAGON-AHLERS | ||||||||
| FirstName: | DAWN | ||||||||
| MiddleName: | |||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 66 SUNSET LAKE RD | ||||||||
| Address2: | |||||||||
| City: | HARDWICK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 078259571 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9735794976 | ||||||||
| FaxNumber: | 9735799007 | ||||||||
| Practice Location | |||||||||
| Address1: | 93 MAIN ST | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | NEWTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 078602056 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9735794976 | ||||||||
| FaxNumber: | 9735799007 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | PC00036 | NJ | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.