Callie Douglass, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

068.0136176 Issued in VT

Practice address

185 Tilley Dr
South Burlington, VT 05403-4484

Phone

(802) 828-7477

NPI assigned

Jun 8, 2020

Last updated

Sep 27, 2024By the provider in NPPES

Sex

Female

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)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1669096434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "768 OLD HOLLOW RD",
            "city": "NORTH FERRISBURGH",
            "state": "VT",
            "postal_code": "054736010",
            "telephone_number": "207-213-3140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 TILLEY DR",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054034484",
            "telephone_number": "802-828-7477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "768 Old Hollow Rd",
            "address_purpose": "LOCATION",
            "city": "North Ferrisburgh",
            "state": "VT",
            "postal_code": "054736010",
            "country_code": "US",
            "telephone_number": "207-213-3140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLASS",
        "first_name": "CALLIE",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-08",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "068.0136176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in South Burlington, VT
• Providers in South Burlington, VT by specialty
• Mental Health Counselor in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.

Verify at the official NPI Registry.