Provider Demographics
NPI:1932374717
Name:DOOR TO HOPE COUNSELING & EDUCATION
Entity Type:Organization
Organization Name:DOOR TO HOPE COUNSELING & EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, CASAC
Authorized Official - Phone:417-724-9767
Mailing Address - Street 1:PO BOX 1049
Mailing Address - Street 2:
Mailing Address - City:NIXA
Mailing Address - State:MO
Mailing Address - Zip Code:65714-1049
Mailing Address - Country:US
Mailing Address - Phone:417-724-9767
Mailing Address - Fax:
Practice Address - Street 1:231 VILLAGE CENTER AVE
Practice Address - Street 2:
Practice Address - City:NIXA
Practice Address - State:MO
Practice Address - Zip Code:65714
Practice Address - Country:US
Practice Address - Phone:417-724-9767
Practice Address - Fax:417-724-9711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO149251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO8002051OtherDMH VENDOR