Active NPI
Richard Marvin Douglass, PSYCHOLOGIST
- Psychologist
- Pleasant Valley, NY
National Provider Identifier
1710262225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 8375
- Practice address
- 1421 Route 44
Pleasant Valley, NY 12569-7832 - Phone
- (845) 723-4373
- Fax
- (845) 635-5189
- NPI assigned
- Oct 15, 2011
- Last updated
- Oct 15, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 8375 | NY | Primary |
Addresses
Primary practice location
1421 Route 44
Pleasant Valley, NY 12569-7832
Mailing address
PO Box 1614
Pleasant Valley, NY 12569-1614
Phone (845) 723-4373
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 |
|---|---|---|---|
| 8375 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318636800000",
"number": "1710262225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1614",
"city": "PLEASANT VALLEY",
"state": "NY",
"postal_code": "125691614",
"telephone_number": "845-723-4373",
"fax_number": "845-635-5189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1421 ROUTE 44",
"city": "PLEASANT VALLEY",
"state": "NY",
"postal_code": "125697832",
"telephone_number": "845-723-4373",
"fax_number": "845-635-5189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLASS",
"first_name": "RICHARD",
"middle_name": "MARVIN",
"name_prefix": "Dr.",
"credential": "PSYCHOLOGIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-15",
"last_updated": "2011-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "8375",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pleasant Valley, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.