Individual provider Active NPI

Janet L Douglas, LCSW

  • Clinical Social Worker
  • Cleburne, TX
National Provider Identifier
1316983687
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
30116 Issued in TX
Practice address
214 N Caddo St
Cleburne, TX 76031-4904
Phone
(817) 558-2988
Fax
(817) 558-3157
NPI assigned
Jun 22, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 30116 TX Primary

Addresses

Primary practice location

214 N Caddo St
Cleburne, TX 76031-4904

Mailing address

214 N Caddo St
Cleburne, TX 76031-4904
Phone (817) 558-2988

Other identifiers 1

IdentifierTypeStateIssuer
1659013MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20040729001617 TX Practitioner - Clinical Social Worker 5395715981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

240 E Renfro St
Suite 201
Burleson, TX 76028-3940
Phone (817) 228-4855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30116TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Country Place Counseling, PLLC Clinical CurrentSince Nov 1, 2010 Accepting new patients
Senior Mental Health Solutions, LP Clinical PastSince Jan 8, 2010 Accepting new patients
Serene Spaces Psychiatry PLLC PastSince Nov 2, 2024 Accepting new patients
Huguley Psychotherapy Clinic, Inc. Clinical Past Accepting new patients

Locations

240 E Renfro St
Ste 201
Burleson, TX 76028
Phone (817) 228-4855

301 Lincoln Park Dr
Cleburne, TX 76033
Phone (817) 514-5282

4255 Bryant Irvin Rd
Ste 101
Fort Worth, TX 76109
Phone (817) 228-4855

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316983687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 N CADDO ST",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760314904",
            "telephone_number": "817-558-2988",
            "fax_number": "817-558-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 N CADDO ST",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760314904",
            "telephone_number": "817-558-2988",
            "fax_number": "817-558-3157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "JANET",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "30116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659013",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleburne, TX

Sources for this page

Verify at the official NPI Registry.