Christopher Douglas

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW13779 Issued in FL

Practice address

4701 Plum Peach BND
Austin, TX 78723-6053

Phone

(561) 339-4596

NPI assigned

Jul 15, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: christopher.douglas.1@30520.direct.athenahealth.com

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.

• Henderson Behavioral Health, Inc.

  • Family Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1053262709
  NPD (past)
• Henderson Behavioral Health, Inc.

  • Community/Behavioral Health Agency
  • Lauderdale Lakes, FL
  • NPI 1972533271
  NPD (past)

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

{
    "created_epoch": "1468540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1205289188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 PLUM PEACH BND",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787236053",
            "telephone_number": "561-339-4596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 PLUM PEACH BND",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787236053",
            "telephone_number": "561-339-4596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "CHRISTOPHER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-15",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW13779",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carissa Anne Dougherty, LCSW
• Eric Dougherty, PHARM.D.
• Jonathan David Dougherty, MD, PHD
• Douglas N. McMullen MD PA
• Camila Douglas, SLPA
• Michal A Douglas, M.D.
• Ryan Douglas, PH.D.
• Sidney Douglas, LCSW
• Cary Dale Douglass, M.D.
• Elizabeth Tate Douglass, MD

• Clinical Social Worker in Austin, TX
• Providers in Austin, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; 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.