Provider Demographics
NPI:1669756961
Name:DOOR IS OPEN COUNSELING CENTER
Entity type:Organization
Organization Name:DOOR IS OPEN COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:DOLBERG ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:781-925-3500
Mailing Address - Street 1:485 NANTASKET AVENUE
Mailing Address - Street 2:UNIT C
Mailing Address - City:HULL
Mailing Address - State:MA
Mailing Address - Zip Code:02045
Mailing Address - Country:US
Mailing Address - Phone:781-925-3500
Mailing Address - Fax:781-925-3505
Practice Address - Street 1:485 NANTASKET AVENUE
Practice Address - Street 2:UNIT C
Practice Address - City:HULL
Practice Address - State:MA
Practice Address - Zip Code:02045
Practice Address - Country:US
Practice Address - Phone:781-925-3500
Practice Address - Fax:781-925-3505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-05
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA91101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1895206Medicaid