Provider Demographics
NPI:1407019805
Name:DBT SKILLS CENTER, PC
Entity Type:Organization
Organization Name:DBT SKILLS CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:TOUCHETTE
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:508-771-5671
Mailing Address - Street 1:572 MAIN ST
Mailing Address - Street 2:UNIT 3
Mailing Address - City:WEST YARMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02673-4909
Mailing Address - Country:US
Mailing Address - Phone:508-771-5671
Mailing Address - Fax:508-790-8301
Practice Address - Street 1:572 MAIN ST
Practice Address - Street 2:UNIT 3
Practice Address - City:WEST YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02673-4909
Practice Address - Country:US
Practice Address - Phone:508-771-5671
Practice Address - Fax:508-790-8301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10305591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1890808Medicaid