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General NPI Number Information
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NPI Number | 1275273054
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Entity Type | Organization
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Legal Business Name | OPEN DOORS TO REDEFINING THERAPEUTIC AND CONSULTING SERVICES LLC
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Dates
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Enumeration Date | 03/30/2022
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Last Update Date | 01/25/2023
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Provider Practice Location Address
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Address Line | 612 SYCAMORE STREET SUITE B
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City | PETERSBURG
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State | VA
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Zip | 23801
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Country | US
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Telephone | 804-446-1461
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 671
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City | PRINCE GEORGE
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State | VA
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Zip | 23875-0600
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Country | US
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Telephone | 804-613-5074
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Fax | 804-799-9196
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Authorized Official
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Title or Position | OWNER
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Name | MRS. BRITNEY MITCHELL
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Credential | LPC
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Telephone | 804-618-5074
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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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