Active NPI
Marilynn Douglas
- Social Worker
- Milwaukee, WI
National Provider Identifier
1639998206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 2141-121
- Practice address
- 6001 W Center St
Milwaukee, WI 53210-2154 - Phone
- (414) 393-1099
- NPI assigned
- Oct 9, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 2141-121 | WI | Primary |
Addresses
Primary practice location
6001 W Center St
Milwaukee, WI 53210-2154
Mailing address
2650 N 22ND St
Milwaukee, WI 53206-1509
Phone (414) 870-4919
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2141-121 | WI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728432000000",
"number": "1639998206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2650 N 22ND ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532061509",
"telephone_number": "414-870-4919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6001 W CENTER ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532102154",
"telephone_number": "414-393-1099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS",
"first_name": "MARILYNN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-09",
"last_updated": "2024-10-09",
"certification_date": "2024-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WI",
"license": "2141-121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.