Healthcare Provider Details

I. General information

NPI: 1003183153
Provider Name (Legal Business Name): GOPI DHOKAI LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2011
Last Update Date: 05/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 CONCORD AVE STE 14
CAMBRIDGE MA
02138-1170
US

IV. Provider business mailing address

545 CONCORD AVE STE 14
CAMBRIDGE MA
02138-1170
US

V. Phone/Fax

Practice location:
  • Phone: 240-506-9768
  • Fax:
Mailing address:
  • Phone: 240-506-9768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9487
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: