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General NPI Number Information
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NPI Number | 1265072219
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Entity Type | Organization
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Legal Business Name | OPEN DOORS COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 01/07/2020
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 503 DARBY CREEK RD STE C
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City | LEXINGTON
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State | KY
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Zip | 40509-1603
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Country | US
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Telephone | 606-776-6185
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Fax |
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Provider Business Mailing Address
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Address Line | 210 E HIGH ST UNIT 394
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City | LEXINGTON
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State | KY
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Zip | 40588-0849
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Country | US
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Telephone | 606-776-6185
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING/ BILLING MANAGER
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Name | DEREK PICKLESIMER
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Credential | MBA
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Telephone | 859-300-1437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #6
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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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