Devon Elizabeth Douglas, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P.08167 Issued in OH

Practice address

6520 Poe Ave
Suite 200
Dayton, OH 45414

Phone

(937) 276-3356

Fax

(937) 276-9514

NPI assigned

Jan 7, 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

• Devon E Brown Former name

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Clinical Psychologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marisa Borgert PSYD LLCGroup PAC ID 0143501197, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Marisa Borgert, Psy.D., LLC

  • Clinical Psychologist
  • Dayton, OH
  • NPI 1780136267
  Medicare reassignment Care Compare group NPD
• Cordell Associates, LLC

  • Clinical Psychologist
  • Dayton, OH
  • NPI 1780735597
  Medicare reassignment NPD

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

{
    "created_epoch": "1515283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1366959751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6520 POE AVE",
            "address_2": "SUITE 200",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45414",
            "telephone_number": "937-276-3356",
            "fax_number": "937-276-9514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6520 POE AVE",
            "address_2": "SUITE 200",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45414",
            "telephone_number": "937-276-3356",
            "fax_number": "937-276-9514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "DEVON",
        "middle_name": "ELIZABETH",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-07",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "P.08167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEVON",
            "last_name": "BROWN",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary Beth Doucette
• Ashley Dougan, LPN
• Allison Dougherty
• Brianah Douglas
• Danielle R Douglas, APRN
• Patricia Wright Douglas, LPN
• Eric Douglass
• Moses Douglass
• Arianna Dover
• Irene Dow

• Clinical Psychologist in Dayton, OH
• Providers in Dayton, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.