Leslie As Douglass Licensed Clinical Social Worker LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

33003543A Issued in IN

Legal business name

LESLIE AS DOUGLASS LICENSED CLINICAL SOCIAL WORKER LLC

Practice address

55 W. Washington St.
Frankfort, IN 46041-1923

Phone

(765) 357-8118

Fax

(765) 766-4241

NPI assigned

Jun 3, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Leslie As Douglass, MSW, LCSW

Title

President/Owner

Phone

(765) 357-8118

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kathy Kurfman, PH.D., HSPP

  • Clinical Psychologist
  • Marion, IN
  • NPI 1700932845
  NPD (past)
• Megan McKinney Ulrich, L.C.S.W.

  • Clinical Social Worker
  • Frankfort, IN
  • NPI 1265652382
  NPD (past)

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321660800000",
    "number": "1316985088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 397",
            "city": "FRANKFORT",
            "state": "IN",
            "postal_code": "460410397",
            "telephone_number": "765-357-8118",
            "fax_number": "765-766-4241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 W. WASHINGTON ST.",
            "city": "FRANKFORT",
            "state": "IN",
            "postal_code": "460411923",
            "telephone_number": "765-357-8118",
            "fax_number": "765-766-4241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LESLIE AS DOUGLASS LICENSED CLINICAL SOCIAL WORKER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2011-11-19",
        "status": "A",
        "authorized_official_last_name": "DOUGLASS",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "AS",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "765-357-8118",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "33003543A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200461950",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Larry D Rothenberger, Inc
• Leahy Audiology and Hearing AIDS LLC (Leahy Audiology and Hearing Aids)
• Ryan David Leahy, AU.D.
• Shiloh Dallas Lee
• Mark R Lentz, NP
• Chelsea P Lewandowski, PHARMD
• Liberty Dialysis - Lafayette LLC (Liberty Dialysis - Frankfort)
• Kylie Light
• Shelby Light
• Amy Renee Lipscomb, APRN

• Mental Health Counselor in Frankfort, IN
• Providers in Frankfort, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2011; 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.