Melissa D. Douglass, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2016031528 Issued in MO

Practice address

1855 Chateau Du Mont Dr
Florissant, MO 63031-1053

Phone

(314) 616-6211

NPI assigned

Jan 6, 2017

Last updated

Oct 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Douglass Enterprises LLC

  dba Goal Driven Counseling LLC

  • Clinical Social Worker
  • Florissant, MO
  • NPI 1659842433
  Authorized official Same address or phone

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

{
    "created_epoch": "1483660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1164968772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 CHATEAU DU MONT DR",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630311053",
            "telephone_number": "314-616-6211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 CHATEAU DU MONT DR",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630311053",
            "telephone_number": "314-616-6211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLASS",
        "first_name": "MELISSA",
        "middle_name": "D.",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-06",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2016031528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Dougherty, CPM
• La'Shay Douglas
• Torace Lamont Douglas, LMT
• Yolanda Douglas
• Douglass Enterprises LLC (Goal Driven Counseling LLC)
• Faith Eileen Dowell
• Dontesia Downs
• Cheyenne Drake
• Monica Elaine Drake
• Rhonda Drake

• Clinical Social Worker in Florissant, MO
• Providers in Florissant, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 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.