Provider Demographics
NPI:1922364637
Name:OPEN DOORS COUNSELING CENTER
Entity Type:Organization
Organization Name:OPEN DOORS COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL-LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC/CACIII
Authorized Official - Phone:719-229-9811
Mailing Address - Street 1:11857 TRISSINO HTS
Mailing Address - Street 2:
Mailing Address - City:FALCON
Mailing Address - State:CO
Mailing Address - Zip Code:80831-4501
Mailing Address - Country:US
Mailing Address - Phone:719-229-9811
Mailing Address - Fax:719-599-7300
Practice Address - Street 1:1880 DUBLIN BLVD STE D
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-1224
Practice Address - Country:US
Practice Address - Phone:719-229-9811
Practice Address - Fax:719-599-7300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO=========OtherTHERAPIST/ INSURANCE