Provider Demographics
NPI:1689172850
Name:DOREEN E. CAHILL LLC
Entity Type:Organization
Organization Name:DOREEN E. CAHILL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:CAHILL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:561-676-0293
Mailing Address - Street 1:5589 FAIRWAY PARK DR APT 101
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-1738
Mailing Address - Country:US
Mailing Address - Phone:561-676-0293
Mailing Address - Fax:
Practice Address - Street 1:4400 N FEDERAL HWY STE 210
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-5195
Practice Address - Country:US
Practice Address - Phone:561-676-0293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FLSW11519261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty