David Douglass, CPRM-DP

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

2081 W Grand Blvd
Detroit, MI 48208-1105

Phone

(313) 895-0500

Fax

(313) 895-0503

NPI assigned

Oct 17, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sobriety House

  • Substance Abuse Rehabilitation Facility
  • Detroit, MI
  • NPI 1386777555
  NPD

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

{
    "created_epoch": "1729123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1851112403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2081 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482081105",
            "telephone_number": "313-895-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2081 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482081105",
            "telephone_number": "313-895-0500",
            "fax_number": "313-895-0503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLASS",
        "first_name": "DAVID",
        "credential": "CPRM-DP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-17",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Denise Douglas
• Karen L. Douglas, NP
• Kimberly Ann Douglas, LPC
• Patricia Douglas
• Ramona Denise Douglas, MSW
• Kathryn Douglass, LMSW
• Doula Me Baby LLC
• Doula Support LLC
• Doulove Birthing Services LLC
• Christopher Charbel Doumith, CGC

• Peer Specialist in Detroit, MI
• Providers in Detroit, MI by specialty
• Peer Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.