| Doorway Therapeutic Services | |
|
298 Grand Ave Ste 100 Oakland CA 94610-4895 | |
| (510) 463-4471 | |
| Not Available |
| Full Name | Doorway Therapeutic Services |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 298 Grand Ave Ste 100, Oakland, California |
| Authorized Official Name and Position | Courtney Watson (CEO) |
| Authorized Official Contact | 5104634471 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Doorway Therapeutic Services 298 Grand Ave Ste 100 Oakland CA 94610-4895 Ph: (510) 463-4471 | Doorway Therapeutic Services 298 Grand Ave Ste 100 Oakland CA 94610-4895 Ph: (510) 463-4471 |
| NPI Number | 1174167191 |
|---|---|
| Provider Enumeration Date | 11/01/2019 |
| Last Update Date | 11/25/2024 |
| Certification Date | 11/25/2024 |
| Medicare PECOS PAC ID | 1759860117 |
|---|---|
| Medicare Enrollment ID | O20260206001224 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174167191 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (NU) | Secondary |
| 1041C0700X | Social Worker - Clinical | (NU) | Secondary |
| 106H00000X | Marriage & Family Therapist | (NU) | Primary |
| Provider Name | Courtney Watson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1902298656 PECOS PAC ID: 2668951021 Enrollment ID: I20260206001290 |
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