NPIMap

Organization Active NPI

The Open Door of Indiana, PA

  • Addiction (Substance Use Disorder) Counselor
  • Indiana, PA
National Provider Identifier
1487710828
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
321050 Issued in PA
Legal business name
THE OPEN DOOR OF INDIANA, PA
Practice address
665 Philadelphia St Ste 202
Indiana, PA 15701-3941
Phone
(724) 465-2605
Fax
(724) 465-2610
NPI assigned
Dec 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Judith Wolfe
Title
Chief Compliance Officer
Phone
(724) 465-2605

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 321050 PA Primary

Addresses

Primary practice location

665 Philadelphia St Ste 202
Indiana, PA 15701-3941

Mailing address

665 Philadelphia St Ste 202
Indiana, PA 15701-3941
Phone (724) 465-2605

Other names 1

  • The Open Door Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2096004The Open Door of Indiana, PA665 Philadelphia St Suite 202, Indiana, PA 15701Certificate of waiverMay 13, 2027

National Provider Directory

National Provider Directory

Locations

665 Philadelphia St
Ste 202
Indiana, PA 15701
Phone (724) 465-2605

334 Philadelphia St
Indiana, PA 15701
Phone (724) 465-2605

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672704000000",
    "number": "1487710828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 PHILADELPHIA ST STE 202",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013941",
            "telephone_number": "724-465-2605",
            "fax_number": "724-465-2610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 PHILADELPHIA ST STE 202",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013941",
            "telephone_number": "724-465-2605",
            "fax_number": "724-465-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE OPEN DOOR OF INDIANA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A",
        "authorized_official_last_name": "WOLFE",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "724-465-2605"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "PA",
            "license": "321050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Open Door",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Open Door",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indiana, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.