Healthcare Provider Details

I. General information

NPI: 1881086791
Provider Name (Legal Business Name): DOCHAS COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2015
Last Update Date: 03/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 THIRD ST
DOVER NH
03820-3316
US

IV. Provider business mailing address

35 THIRD ST
DOVER NH
03820-3316
US

V. Phone/Fax

Practice location:
  • Phone: 603-285-1667
  • Fax: 603-516-0769
Mailing address:
  • Phone: 603-285-1667
  • Fax: 603-516-0769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0676
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1030
License Number StateNH

VIII. Authorized Official

Name: MISS JULIA MARIE REILLY
Title or Position: PROPRIETOR
Credential: LCMHC, MLADC, CFC
Phone: 603-285-1667