Active NPI
Douglass Paul, LMHC, QS, LPC
- Professional Counselor
- Orlando, FL
National Provider Identifier
1285701425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC005791
- Practice address
- 1619 Hanks Ave
Orlando, FL 32814-6707 - Phone
- (678) 477-8747
- NPI assigned
- Nov 30, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH17517 | FL | |
| Professional Counselor | 101YP2500X | LPC005791 | GA | Primary |
Addresses
Primary practice location
1619 Hanks Ave
Orlando, FL 32814-6707
Mailing address
1619 Hanks Ave
Orlando, FL 32814-6707
Phone (678) 477-8747
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MH17517 | Other | FL | FL BOARD OF MHC |
| LPC005791 | Other | GA | GA COMPOSITE BOARD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH17517 | FL | MD | Mental Health Counselor |
| LPC005791 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585526400000",
"number": "1285701425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1619 HANKS AVE",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328146707",
"telephone_number": "678-477-8747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1619 HANKS AVE",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328146707",
"telephone_number": "678-477-8747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAUL",
"first_name": "DOUGLASS",
"credential": "LMHC, QS, LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-30",
"last_updated": "2020-03-30",
"certification_date": "2020-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH17517",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC005791",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FL BOARD OF MHC",
"identifier": "MH17517",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GA COMPOSITE BOARD",
"identifier": "LPC005791",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.