Provider Demographics
NPI:1902933815
Name:DOHERTY, PAUL FRANCIS (LMHC)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:FRANCIS
Last Name:DOHERTY
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 812911
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482-0027
Mailing Address - Country:US
Mailing Address - Phone:617-686-9249
Mailing Address - Fax:
Practice Address - Street 1:14 BEACON ST
Practice Address - Street 2:SUITE 801
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02108-3704
Practice Address - Country:US
Practice Address - Phone:617-227-2622
Practice Address - Fax:617-227-5447
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5304101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health