Active NPI
Angela C. Douglas, LCSW
- Clinical Social Worker
- Gilbert, AZ
National Provider Identifier
1770797383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LSCW 11606
- Practice address
- 428 S Gilbert Rd Ste 106-5
Gilbert, AZ 85296-2263 - Phone
- (480) 345-1313
- NPI assigned
- May 10, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LSCW 11606 | AZ | Primary |
Addresses
Primary practice location
428 S Gilbert Rd Ste 106-5
Gilbert, AZ 85296-2263
Mailing address
8234 E Obispo Ave
Mesa, AZ 85212-1614
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 |
|---|---|---|---|
| LSCW 11606 | AZ | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1499817600000",
"number": "1770797383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8234 E OBISPO AVE",
"city": "MESA",
"state": "AZ",
"postal_code": "852121614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "428 S GILBERT RD STE 106-5",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852962263",
"telephone_number": "480-345-1313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS",
"first_name": "ANGELA",
"middle_name": "C.",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-10",
"last_updated": "2017-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AZ",
"license": "LSCW 11606",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.