Healthcare Provider Details

I. General information

NPI: 1922998715
Provider Name (Legal Business Name): THERAPY NICHE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2025
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 THE GRN STE 17492
DOVER DE
19901-3618
US

IV. Provider business mailing address

340 N GOVERNORS AVE
DOVER DE
19904-3006
US

V. Phone/Fax

Practice location:
  • Phone: 302-344-0504
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: RAENISHA MARIE WATSON
Title or Position: CEO/ MENTAL HEALTH THERAPY
Credential: LPCMH
Phone: 302-344-0504