Andrea Race Douglass, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

116215 Issued in MA

Practice address

1025 Massachusetts Ave
Arlington, MA 02476-4503

Phone

(617) 615-6353

NPI assigned

Oct 31, 2008

Last updated

Nov 10, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1225411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415577600000",
    "number": "1255584462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MASSACHUSETTS AVE",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024764503",
            "telephone_number": "617-615-6353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MASSACHUSETTS AVE",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024764503",
            "telephone_number": "617-615-6353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLASS",
        "first_name": "ANDREA",
        "middle_name": "RACE",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-31",
        "last_updated": "2014-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "116215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela L Donleavy, J.D., NCPSYA
• Colleen Lee Donovan, RN
• Noreen M Donovan, PH.D.
• Andrew Stover Doolittle, PHARMD
• David Stuart Douglas, MSW, LICSW
• Shauna Lynn Dowden, PH.D.
• Linda R. Downey, PSY.D.
• Marilyn Frances Downs, PHD, LICSW
• Mary McCallum Downs
• Dianne Doyle-Pita

• Clinical Social Worker in Arlington, MA
• Providers in Arlington, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; 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.