Provider Demographics
NPI:1528836905
Name:OPEN DOOR COUNSELING LLC
Entity type:Organization
Organization Name:OPEN DOOR COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:L
Authorized Official - Last Name:ZICKEFOOOSE
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:208-570-4350
Mailing Address - Street 1:16548 SNOWGOOSE ST
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83687-8293
Mailing Address - Country:US
Mailing Address - Phone:208-570-4350
Mailing Address - Fax:208-498-2008
Practice Address - Street 1:849 E FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-1806
Practice Address - Country:US
Practice Address - Phone:208-570-4350
Practice Address - Fax:208-498-2008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-15
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty