Susan Rae Douglas, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P0000003182 Issued in TN

Practice address

6544 Murray LN
The Diagnostic Center at Currey Ingram Academy
Brentwood, TN 37027-5515

Phone

(615) 507-3171

NPI assigned

Apr 27, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461715200000",
    "number": "1720433774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2532 BLAIR BLVD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372124808",
            "telephone_number": "615-423-0183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6544 MURRAY LN",
            "address_2": "THE DIAGNOSTIC CENTER AT CURREY INGRAM ACADEMY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275515",
            "telephone_number": "615-507-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "SUSAN",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-27",
        "last_updated": "2016-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P0000003182",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7883",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olena Dorokhova, M.D., PHD
• Doug Hassenpflug PLLC
• Je'Lynn Douglas
• Justin Lee Douglas, DDS
• Quade Austin Douglas
• Katelyn Dover, M.ED.
• Christianne Marie Downey, M.A. LPC/MHSP
• Dr Mark Lynn & Associates PLLC (Visionworks Doctors of Optometry)
• Dr. Alan Ballard and Associates (Ballard Vision Associates)
• Dr. Timothy M Ruff, MD, PLLC

• Clinical Psychologist in Brentwood, TN
• Providers in Brentwood, TN by specialty
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2016; 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.