Provider Demographics
NPI:1912200833
Name:DOUCETTE, CODY ALAN
Entity Type:Individual
Prefix:MR
First Name:CODY
Middle Name:ALAN
Last Name:DOUCETTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 GLEN RD
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-2323
Mailing Address - Country:US
Mailing Address - Phone:781-593-5322
Mailing Address - Fax:
Practice Address - Street 1:8 GLEN RD
Practice Address - Street 2:
Practice Address - City:SWAMPSCOTT
Practice Address - State:MA
Practice Address - Zip Code:01907-2323
Practice Address - Country:US
Practice Address - Phone:781-593-5322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-15
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator