Active NPI
Carla Ann Douglass
- Clinical Psychologist
- Chesapeake, VA
National Provider Identifier
1124946017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6362010266
- Practice address
- 2010 Old Greenbrier Rd Ste B
Chesapeake, VA 23320-2619 - Phone
- (757) 702-3206
- Fax
- (757) 702-3261
- NPI assigned
- Jul 8, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6362010266 | MI | Primary |
Addresses
Primary practice location
2010 Old Greenbrier Rd Ste B
Chesapeake, VA 23320-2619
Mailing address
2010 Old Greenbrier Rd Ste B
Chesapeake, VA 23320-2619
Phone (757) 702-3206
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Psychological Services | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1783468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783468800000",
"number": "1124946017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2010 OLD GREENBRIER RD STE B",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233202619",
"telephone_number": "757-702-3206",
"fax_number": "757-702-3261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2010 OLD GREENBRIER RD STE B",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233202619",
"telephone_number": "757-702-3206",
"fax_number": "757-702-3261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLASS",
"first_name": "CARLA",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-07-08",
"last_updated": "2026-07-08",
"certification_date": "2026-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6362010266",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesapeake, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.