Douglass Community Association

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

390183 Issued in MI

Legal business name

DOUGLASS COMMUNITY ASSOCIATION

Practice address

1000 W Paterson St
Kalamazoo, MI 49007-1710

Phone

(269) 343-6185

Fax

(269) 492-1749

NPI assigned

Apr 23, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Timothy R Terrentine

Title

Executive Director

Phone

(269) 343-6185

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093933210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W PATERSON ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490071710",
            "telephone_number": "269-343-6185",
            "fax_number": "269-492-1749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W PATERSON ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490071710",
            "telephone_number": "269-343-6185",
            "fax_number": "269-492-1749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLASS COMMUNITY ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TERRENTINE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "269-343-6185",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "390183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adriana Wieczorkowski Doud, NP
• Douglas Allen Dougherty
• Elizabeth Anne Douglas, M.D.
• Holly Lynn Douglas, CTRS
• Kacey Lee Douglas, NP
• Jessica A Douglass
• Tanya N Douleh, TLLP
• Ella Doumanian
• Pamela L Dowd, NP
• Annabelle Dowdy

• Addiction (Substance Use Disorder) Counselor in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Addiction (Substance Use Disorder) Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.