Individual provider Active NPI

Diepriye Caitlin Douglas

  • Clinical Social Worker
  • Rosenberg, TX
National Provider Identifier
1902170947
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
57595 Issued in TX
Practice address
5500 Avenue N
Rosenberg, TX 77471-5652
Phone
(281) 238-0852
NPI assigned
Mar 7, 2012
Last updated
Jul 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 084271-1 NY
Clinical Social Worker 1041C0700X 57595 TX Primary

Addresses

Primary practice location

5500 Avenue N
Rosenberg, TX 77471-5652

Mailing address

5500 Avenue N
Rosenberg, TX 77471-5652
Phone (281) 238-0852

Other practice location 1

2020 Coney Island Ave
Brooklyn, NY 11223-2329
Phone (718) 676-4281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20250912003959 CT Practitioner - Clinical Social Worker 6709317308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
084271-1NYMDSocial Worker
57595TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hermann Community Benefit Corporation PastSince May 28, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1902170947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 AVENUE N",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774715652",
            "telephone_number": "281-238-0852",
            "fax_number": "281-238-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 AVENUE N",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774715652",
            "telephone_number": "281-238-0852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2020 Coney Island Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112232329",
            "country_code": "US",
            "telephone_number": "718-676-4281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "DIEPRIYE",
        "middle_name": "CAITLIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-07",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "084271-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "57595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosenberg, TX

Sources for this page

Verify at the official NPI Registry.