Mayra Garcia Douglas, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.030151 Issued in IL

Practice address

136 W Lake St Ste 100
Bloomingdale, IL 60108-1064

Phone

(630) 343-9528

NPI assigned

Aug 12, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Mayra Garcia Rodriguez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1356172233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S WALNUT LN",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601931004",
            "telephone_number": "630-812-8816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 W LAKE ST STE 100",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601081064",
            "telephone_number": "630-343-9528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "MAYRA",
        "middle_name": "GARCIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150113815",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.030151",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "150.113815",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "150.113815",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAYRA",
            "last_name": "GARCIA RODRIGUEZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ammar Y Divan, MD
• DME Medical Logistics
• DME Solutions LLC
• Candice Marie Domke-Hochberg, LMT,NCBTMB
• Elvin Donald
• Therese Marie Doyle, CNM
• Dr Paul K Rosenberg, LTD
• Dr Paul K. Rosenberg, LTD
• Dr.Lalita Batra & Associates
• Sylwia Drag, LSW

• Clinical Social Worker in Bloomingdale, IL
• Providers in Bloomingdale, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; 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.