Gregory Landells Douglas, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

73 047347 Issued in NY

Practice address

1276 Fulton Ave
Bronx, NY 10456-3402

Phone

(718) 901-8222

Fax

(718) 466-6098

NPI assigned

Jan 28, 2009

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1233100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233100800000",
    "number": "1568600625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "718-901-8222",
            "fax_number": "718-466-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "718-901-8222",
            "fax_number": "718-466-6098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "GREGORY",
        "middle_name": "LANDELLS",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-28",
        "last_updated": "2009-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "73 047347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Bennet Herzlich DPM PC
• Alexandra Welch Douglas, MD-MPH
• Alina Douglas
• Andrew Walter Douglas, RPA-C
• Gaveral Douglas
• Gretchen Douglas
• Jennifer Douglas, OTD, OTR/L
• Karimah Ayana Douglas, OTR
• Kemberly Douglas
• Margarette Douglas, RN

• Clinical Social Worker in Bronx, NY
• Providers in Bronx, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; 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.