Mellisa Gail Douglas, M.ED,LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

0701004135 Issued in VA

Practice address

71 Wilson Blvd Ste A1
Fishersville, VA 22939-2283

Phone

(540) 949-4202

Fax

(540) 886-7380

NPI assigned

Aug 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians

Augusta Psychological AssociatesGroup PAC ID 4880663764, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

State licenses

Practice roles

Locations

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.

• Augusta Psychological Associates

  • Psychosomatic Medicine Physician
  • Fishersville, VA
  • NPI 1053416495

  Professional

  Medicare reassignment Care Compare group NPD
• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  Professional, VA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385942400000",
    "number": "1720194681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 BURNSVILLE RD",
            "city": "WILLIAMSVILLE",
            "state": "VA",
            "postal_code": "244872148",
            "telephone_number": "540-396-3379",
            "fax_number": "540-886-7380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 WILSON BLVD STE A1",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392283",
            "telephone_number": "540-949-4202",
            "fax_number": "540-886-7380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "MELLISA",
        "middle_name": "GAIL",
        "credential": "M.ED,LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2013-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "17005",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "VA",
            "license": "0701004135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162090801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Noel Patrice Dianas-Hughes, LCSW
• Payton Hatcher Dickman, PA-C
• Barry Kent Diduch, MD
• Alison Dickinson Dodd, PA-C
• Kenneth William Donohue, PA
• Ryan Downing
• Robert Marvin Driscoll, DDS
• Meghan Driver, OTR/L
• Laurie S Du Bose, O.T.
• Christina Elizabeth Dubay, C.N.M

• Counselor in Fishersville, VA
• Providers in Fishersville, VA by specialty
• Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.