Provider Demographics
NPI:1740805357
Name:HARRINGTON DOOLEY, JOSE RAFAEL (LICSW)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:RAFAEL
Last Name:HARRINGTON DOOLEY
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:963 ROBERT ST S
Mailing Address - Street 2:
Mailing Address - City:WEST SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55118-1446
Mailing Address - Country:US
Mailing Address - Phone:612-886-4785
Mailing Address - Fax:
Practice Address - Street 1:963 ROBERT ST S
Practice Address - Street 2:
Practice Address - City:WEST SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55118-1446
Practice Address - Country:US
Practice Address - Phone:612-886-4785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN26691104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker