Kemba Douglas, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC.0018843 Issued in CO

Practice address

3303 W 144TH Ave Unit 204
Broomfield, CO 80023-9601

Phone

(720) 709-2810

NPI assigned

Jul 10, 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

Enrolled in CO

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

Credentials

Master of Arts

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kemba.douglas.p2@direct.communityreachcenter.nextgenshare.com

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.

• Krueger Emh Inc.

  dba Ellie Mental Health

  • Mental Health Counselor
  • Broomfield, CO
  • NPI 1114640356
  NPD

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1487206447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 W 144TH AVE UNIT 204",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800239601",
            "telephone_number": "720-709-2810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 W 144TH AVE UNIT 204",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800239601",
            "telephone_number": "720-709-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "KEMBA",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-10",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0018843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Thomas Dorn, PHARMD
• Robert James Dorr, M.A.
• Anaya L Dorsett
• Allison Douglas Guerrero, LPC
• Sarah Douglas-Broten, D.M.D.
• Skye Elizabeth Douglas, DMD
• Elizabeth Kate Downey, LCSW
• Dr. Emily Baker, PC
• Dr. Hani M. Marogil DMD PC
• Allyson Drago, LCSW

• Professional Counselor in Broomfield, CO
• Providers in Broomfield, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; 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.