Elise Marguerite Douglas, LPC
Individual provider Active NPI Counselor · Sulpher Springs, TX
NPI 1083789044 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1083789044
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 15505 (TX)
- Practice address
- 2121 Main Street
Sulpher Springs, TX 75482 - Phone
- (903) 885-2776
- Fax
- (903) 885-3613
- NPI assigned
- Nov 22, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15505 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jennifer Staten, LCSW, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 15505 | TX | Yes |
Addresses
Primary practice location
2121 Main Street
Sulpher Springs, TX 75482
Mailing address
PO Box 146
Sulpher Springs, TX 75483-0146
Phone (903) 885-2776
Other providers in Sulpher Springs, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.