Jessica Douglas

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2745 Issued in AL

Practice address

112 Coliseum Blvd
Montgomery, AL 36109-2708

Phone

(334) 279-7810

NPI assigned

Dec 6, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Montgomery Area Mental Health Authority Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Montgomery, AL
  • NPI 1710012398
  NPD

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

{
    "created_epoch": "1575590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1336786540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3223",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361090223",
            "telephone_number": "334-279-7830",
            "fax_number": "334-277-8862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 COLISEUM BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361092708",
            "telephone_number": "334-279-7810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Academy Ln",
            "address_purpose": "LOCATION",
            "city": "Hayneville",
            "state": "AL",
            "postal_code": "360402617",
            "country_code": "US",
            "telephone_number": "334-279-7830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-06",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AL",
            "license": "2745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leandrea J'Neyel Dorsey, PHARMD
• Christopher J Dorvault, M.D.
• Pankil Prakashchandra Doshi, MD
• Adedoyin B Dosunmu-Ogunbi, M.D.
• Brenda Lee Douberly, MS,CCC-SLP
• Vernisha Chambers Douglas, RN
• Dove Physical Therapy, LLC
• Kelcie Brielle Downer, DDS
• David M Downs, MD
• Natalie Downs, AGNP-C

• Mental Health Counselor in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Mental Health Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2019; 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.