Constance Douglas, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

071290 Issued in NY

Practice address

11 W Prospect Ave FL 4
C/O WJCS
Mount Vernon, NY 10550-2017

Phone

(914) 668-8938

Fax

(914) 668-2545

NPI assigned

Oct 13, 2016

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

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476316800000",
    "number": "1376093344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 W PROSPECT AVE FL 4",
            "address_2": "C/O WJCS",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502017",
            "telephone_number": "914-668-8938",
            "fax_number": "914-668-2545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 W PROSPECT AVE FL 4",
            "address_2": "C/O WJCS",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502017",
            "telephone_number": "914-668-8938",
            "fax_number": "914-668-2545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "CONSTANCE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-13",
        "last_updated": "2016-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "071290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John J Dioguardi, CASAC
• Debbi-Ann Dixon
• Marva Dolphin
• Loretta Dolphus II
• Sabrina Dominique, MS CCC-SLP
• Nicola Douglas, LPN
• Robert Leslie Douglas, LMHC
• Maxine E Dove, D.D.S.
• Loretta Kari Dowlat-Corbanese
• Patricia Rosemary Downer-Bandoo, RN

• Social Worker in Mount Vernon, NY
• Providers in Mount Vernon, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; 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.