Jennifer Lara Dougall, PHD, PCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.0007143 Issued in OH

Practice address

444 N Main St
Suite 408
Akron, OH 44310-3110

Phone

(330) 805-4587

Fax

(330) 805-4587

NPI assigned

Mar 6, 2014

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Olive Branch Counseling and Wellness, LLC

  • Community/Behavioral Health Agency
  • Akron, OH
  • NPI 1932522356
  NPD (past) Authorized official

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

{
    "created_epoch": "1394064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394064000000",
    "number": "1619393287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4034",
            "city": "COPLEY",
            "state": "OH",
            "postal_code": "443210034",
            "telephone_number": "330-805-4587",
            "fax_number": "330-805-4587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 N MAIN ST",
            "address_2": "SUITE 408",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443103110",
            "telephone_number": "330-805-4587",
            "fax_number": "330-805-4587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGALL",
        "first_name": "JENNIFER",
        "middle_name": "LARA",
        "name_prefix": "Dr.",
        "credential": "PHD, PCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-06",
        "last_updated": "2014-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.0007143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Janeen Dorsey, LPN
• Victoria Dorsey, RN
• Teidra J Dortch, PC
• Amanda Dos Santos, MD
• Timothy Doss, CDCA
• Brian Christopher Dougherty
• Christopher Joseph Dougherty, LPCC
• James M Dougherty, MD
• Katie Dougherty, MS, RD, LD
• Josephine Doughman, MD

• Professional Counselor in Akron, OH
• Providers in Akron, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2014; 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.