Individual provider Active NPI

Ann Douglas, PHD

  • Professional Counselor
  • Missoula, MT
National Provider Identifier
1629742978
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
BBH-LCPC-LIC-78437 Issued in MT
Practice address
900 N Orange St Ste 202
Missoula, MT 59802-2951
Phone
(406) 327-3362
Fax
(406) 327-3349
NPI assigned
Aug 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY-PSY-TMP-3549 MT
Professional Counselor 101YP2500X BBH-LCPC-LIC-78437 MT Primary

Addresses

Primary practice location

900 N Orange St Ste 202
Missoula, MT 59802-2951

Mailing address

PO Box 31001-4110
Pasadena, CA 91110-4110
Phone (406) 327-3362

Other practice location 1

656 Agency Main St
Harlem, MT 59526-9455
Phone (406) 396-8321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250410002856 MT Practitioner - Mental Health Counselor 8527582550 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY-PSY-TMP-3549MTMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Mt CurrentSince Mar 2, 2025 Accepting new patients
Providence Health & Services Mt CurrentSince Mar 2, 2025 Accepting new patients
Providence Health & Services Mt Current Accepting new patients

Locations

500 W Broadway St
Ste 320
Missoula, MT 59802
Phone (406) 329-2945

900 N Orange St
Ste 202
Missoula, MT 59802
Phone (406) 327-1670

Interoperability endpoints

  • Direct secure messaging: ann.dogulas@allnations.directbygreenway.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1629742978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-4110",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911104110",
            "telephone_number": "406-327-3362",
            "fax_number": "406-327-3349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N ORANGE ST STE 202",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598022951",
            "telephone_number": "406-327-3362",
            "fax_number": "406-327-3349"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "656 Agency Main St",
            "address_purpose": "LOCATION",
            "city": "Harlem",
            "state": "MT",
            "postal_code": "595269455",
            "country_code": "US",
            "telephone_number": "406-396-8321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-02",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MT",
            "license": "PSY-PSY-TMP-3549",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MT",
            "license": "BBH-LCPC-LIC-78437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.