Active NPI
Jamie S. Douglas, MA LMHC LMFTA ICACII
- Mental Health Counselor
- Attica, IN
National Provider Identifier
1780981001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 39002241A
- Practice address
- 304 S. Perry St
Attica, IN 47918 - Phone
- (765) 762-0611
- NPI assigned
- Feb 23, 2011
- Last updated
- Feb 23, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39002241A | IN | Primary |
| Marriage & Family Therapist | 106H00000X | 85000031A | IN |
Addresses
Primary practice location
304 S. Perry St
Attica, IN 47918
Mailing address
702 S Washington St
Crawfordsville, IN 47933-3409
Phone (765) 376-3225
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39002241A | IN | MD | Mental Health Counselor |
| 85000031A | IN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298419200000",
"number": "1780981001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "702 S WASHINGTON ST",
"city": "CRAWFORDSVILLE",
"state": "IN",
"postal_code": "479333409",
"telephone_number": "765-376-3225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 S. PERRY ST",
"city": "ATTICA",
"state": "IN",
"postal_code": "47918",
"telephone_number": "765-762-0611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS",
"first_name": "JAMIE",
"middle_name": "S.",
"credential": "MA LMHC LMFTA ICACII",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-02-23",
"last_updated": "2011-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39002241A",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IN",
"license": "85000031A",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Attica, IN
- Kara Lynn Clayton, MSW, LCSW
- Crossroads Recovery Services
- Daviess County Hospital
- Davis Drugs LLC (Davis Drugs)
- Davis Drugs, LLC (Davis Drugs)
- Families United, Inc.
- Fountain County Auditor (Fountain Warren County Health Department)
- Yessenia I Girdler, LCSW
- Sarah Haas, LCSW
- Hook-Superx LLC (CVS Pharmacy #06673)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.