Individual
MR. LARRY PATRICK DAHLKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA LMSW LLP CAAC
Contact information
Practice address
26184 OUTER DR, LINCOLN PARK, MI 48146-2084
(313) 389-7563
(313) 389-7510
Mailing address
3966 GERTRUDE ST, DEARBORN HEIGHTS, MI 48125-2814
(313) 565-3273
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C-00116
MI
103T00000X
Psychologist
1811089
MI
1041C0700X
Clinical Social Worker
1757155
MI
Other
Enumeration date
02/01/2007
Last updated
09/11/2025
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