Adrienne Leigh Douglas, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4101-C Issued in AR

Practice address

105 Cox St
Benton, AR 72015-4611

Phone

(501) 776-5779

Fax

(501) 217-9757

NPI assigned

May 18, 2011

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

Medicare fee-for-service enrollment

Enrolled in AR

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

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.

• Inspiration Day Treatment, Inc.

  • Community/Behavioral Health Agency
  • Little Rock, AR
  • NPI 1811141807

  AR

  Medicare reassignment Care Compare group NPD

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Inspiration Day Treatment, Inc. 8 clinicians

Practice addresses (Care Compare)

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

{
    "created_epoch": "1305676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1487947867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 ALDERSGATE RD STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056676",
            "telephone_number": "501-661-0720",
            "fax_number": "501-325-7938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 COX ST",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720154611",
            "telephone_number": "501-776-5779",
            "fax_number": "501-217-9757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "ADRIENNE",
        "middle_name": "LEIGH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "4101-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Diane Dodson, LPC
• Whitney Donahue
• Joseph Donnelly, CMP
• Andrew Donovan, LAC
• Carolyn Dotson, QBHP
• Susan Douglas, MHPP
• Dr Q Pain & Spine Clinic, PA
• Dream Big Pediatric Therapies
• Stacy Whittaker Drennan, LMSW
• Amy Christine Dubrava, RN

• All providers in Benton, AR
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.