Rubby M Douglas, LCSW
Individual provider Active NPI Clinical Social Worker · Clinton, LA
NPI 1275820573 · NPPES record last updated Jul 7, 2011
Key facts
- NPI
- 1275820573
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 5057 (LA)
- Practice address
- 11990 Jackson St
Clinton, LA 70722-3210 - Phone
- (225) 683-5292
- Fax
- (225) 683-3411
- NPI assigned
- Jul 7, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5057 | LA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 5057 | LA | Yes |
Addresses
Primary practice location
11990 Jackson St
Clinton, LA 70722-3210
Mailing address
PO Box 395
Clinton, LA 70722-0395
Phone (225) 683-5292
Other providers in Clinton, LA
- Charles M Dear
- Lauren Dees
- Rhonda Martin Delee
- Christy Michelle Denicola
- Justin Joseph Dillard
- Fallon E. Duck
- Stacy Marie Dugas
- Catherine Verberne Easley
- East Feliciana Council on Aging, Inc.
- East Feliciana Parish School Board
All providers in Clinton, LA · Clinical Social Worker in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.