Ryan Douglas, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

87343 Issued in CA

Practice address

1244 Solstice LN
Fort Collins, CO 80525-1253

Phone

(707) 799-8875

NPI assigned

Sep 9, 2009

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

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ryan.douglas.p1@direct.sokya.nextgenshare.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.

• LGTC Group

  • Marriage & Family Therapist
  • San Jose, CA
  • NPI 1881482941

  Clinical

  NPD (past)
• Los Gatos Therapy Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Jose, CA
  • NPI 1518600972
  NPD (past)
• WK Medical Group

  • Psychiatry Physician
  • San Jose, CA
  • NPI 1588083992

  Clinical

  NPD (past)

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

{
    "created_epoch": "1252454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1265765259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5060 SHOREHAM PL STE 330",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225976",
            "telephone_number": "707-799-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 SOLSTICE LN",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805251253",
            "telephone_number": "707-799-8875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "RYAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-09",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "09923823",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "87343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scarlett Dougherty
• Elissa Douglas, RN
• Kaitlin Douglas, MS, LMFT
• Kyle Douglas, LMFT
• Lanny Douglas, APRN
• David I Douphrate, MPT MBA
• Jocelyn Brooks Mavec Dove, MA
• Simon Peter Ferraro Dove, D.C.
• Tristan Joseph Dow, M.D.
• Angela Dowling, RN

• Mental Health Counselor in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.