Provider Demographics
NPI:1598817322
Name:DOIRON, DAVID EMERY (DMIN LIC PSY)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:EMERY
Last Name:DOIRON
Suffix:
Gender:M
Credentials:DMIN LIC PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 GRAFTON ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-3815
Mailing Address - Country:US
Mailing Address - Phone:508-981-5627
Mailing Address - Fax:
Practice Address - Street 1:41 HAMILTON ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-2201
Practice Address - Country:US
Practice Address - Phone:508-981-5627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X
MA373106H00000X
MA3321103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW03397OtherBLUE CROSS BLUE SHIELD
MA00572OtherVALUE OPTION
MA9428115OtherPHCS PRIVATE HEALTHCARE
MAW03397OtherBLUE CROSS BLUE SHIELD