Emilie Douglas, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

LBA627 Issued in TN

Practice address

9038 Cross Park Dr Ste 105
Knoxville, TN 37923-4720

Phone

(865) 983-1899

Fax

(865) 315-7014

NPI assigned

Jan 15, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Emilie Conard Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• ABA Interventions, LLC

  • Behavior Analyst
  • Knoxville, TN
  • NPI 1609235910
  NPD (past)
• Hopebridge LLC

  • Child & Adolescent Psychiatry Physician
  • Brentwood, TN
  • NPI 1881352177

  Behavior Analyst

  NPD (past)

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

{
    "created_epoch": "1515974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1356859151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9038 CROSS PARK DR STE 105",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234720",
            "telephone_number": "865-983-1899",
            "fax_number": "865-315-7014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9038 CROSS PARK DR STE 105",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234720",
            "telephone_number": "865-983-1899",
            "fax_number": "865-315-7014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "EMILIE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-15",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "TN",
            "license": "RBT-17-33554",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TN",
            "license": "LBA627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILIE",
            "last_name": "CONARD",
            "credential": "RBT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Leanne Ingle Dougherty, LCSW DSW
• Phillip James Dougherty, DO
• Allison Cooke Douglas, MS
• Donald R Douglas, PA
• Elizabeth Marcie Douglas, LPN
• Gregory Lamont Douglas, MS
• Jeffrey Lee Douglas, M.D.
• Jessica Douglas, LCSW
• Jimmy Douglas
• Lauren Grace Douglas

• Behavior Analyst in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Behavior Analyst in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.

Verify at the official NPI Registry.