Provider Demographics
NPI:1750195749
Name:BEYOND CLOSED DOORS THERAPY PLLC
Entity type:Organization
Organization Name:BEYOND CLOSED DOORS THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AZARIA
Authorized Official - Middle Name:ZHANE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:631-965-9493
Mailing Address - Street 1:225 RESERVE BLVD APT 302
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-1665
Mailing Address - Country:US
Mailing Address - Phone:631-965-9493
Mailing Address - Fax:
Practice Address - Street 1:10246 DALE DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2302
Practice Address - Country:US
Practice Address - Phone:301-799-5216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-03
Last Update Date:2025-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)