Provider Demographics
NPI:1134667850
Name:DOORWAYS OUTREACH
Entity Type:Organization
Organization Name:DOORWAYS OUTREACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MEINKE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:727-644-5755
Mailing Address - Street 1:47 ROWLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-1234
Mailing Address - Country:US
Mailing Address - Phone:727-644-5755
Mailing Address - Fax:
Practice Address - Street 1:47 ROWLAND AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-1234
Practice Address - Country:US
Practice Address - Phone:727-644-5755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-01
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW12472104100000X
NJ44SC05695500104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty