Provider Demographics
NPI:1841168911
Name:ORANGE DOOR COLLABORATIVE, PLLC
Entity type:Organization
Organization Name:ORANGE DOOR COLLABORATIVE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAOMI
Authorized Official - Middle Name:TAMARA
Authorized Official - Last Name:AZAR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:617-209-9866
Mailing Address - Street 1:763 MASSACHUSETTS AVE STE 7
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-3329
Mailing Address - Country:US
Mailing Address - Phone:508-507-7759
Mailing Address - Fax:617-977-2135
Practice Address - Street 1:763 MASSACHUSETTS AVE STE 7
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-3329
Practice Address - Country:US
Practice Address - Phone:508-507-7759
Practice Address - Fax:617-977-2135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-29
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty