Elizabeth Jones Douglass, MSW,MAED,LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

003610 Issued in MO

Practice address

77 West Port Plaza Drive
Suite 360
St. Louis, MO 63146

Phone

(314) 432-1462

NPI assigned

May 30, 2007

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

Other names 1

• Mrs. Betsy Jones Douglass Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710188321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 BRIARCLIFF",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631241753",
            "telephone_number": "314-432-1712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 WEST PORT PLAZA DRIVE",
            "address_2": "SUITE 360",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63146",
            "telephone_number": "314-432-1462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLASS",
        "first_name": "ELIZABETH",
        "middle_name": "JONES",
        "name_prefix": "Mrs.",
        "credential": "MSW,MAED,LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "003610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETSY",
            "last_name": "DOUGLASS",
            "middle_name": "JONES",
            "prefix": "MRS.",
            "credential": "MSW MAED LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Mary Ellen Douglas, BSW
• Teconda Lashelle Douglas, ANP-BC
• Trelford Owen Matthew Douglas, MD
• Zachary Hill Douglas, MD
• Douglass T. Domoto, M.D., J.D., P.C.
• Jhony Y Doumit, MD
• Douthit Home Care Services, LLC
• Traci R Doutre, NBC-HWC
• Dove Cares CDS, LLC
• Dove Mastectomy Supply, LLC

• Clinical Social Worker in St. Louis, MO
• Providers in St. Louis, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.