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General NPI Number Information
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NPI Number | 1144936626
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Entity Type | Organization
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Legal Business Name | OPENING NEW DOORS LLC
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Dates
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Enumeration Date | 01/27/2023
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 800 HILTON RD STE 5
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City | FERNDALE
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State | MI
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Zip | 48220-2505
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Country | US
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Telephone | 248-417-0248
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Fax | 248-665-8685
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Provider Business Mailing Address
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Address Line | 800 HILTON RD STE 5
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City | FERNDALE
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State | MI
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Zip | 48220-2505
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Country | US
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Telephone | 248-238-8074
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | NEOSHUA BUTLER
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Credential | LMSW
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Telephone | 248-238-8074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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