Kathryn Anne Douglas, BCBA, LCPC, LPCC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-19-35663 Issued in IL

Practice address

535 Maine St
Quincy, IL 62301-3950

Phone

(217) 577-2176

NPI assigned

Sep 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1922102409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2909 SELKIRK LN",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623056525",
            "telephone_number": "415-580-0239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623013950",
            "telephone_number": "217-577-2176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "KATHRYN",
        "middle_name": "ANNE",
        "credential": "BCBA, LCPC, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-12",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180007537",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2009032566",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "13837",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "1-19-35663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Elaine Dooley, NOVICE INTERPRETER
• Tonya Jo Dooley, P.T.
• Kathy Dopheide, PTA
• Chris Dougherty
• William E. Dougherty, M.D.
• Martinette Z Douglas
• Sara Nicole Douglas
• Teresa Iva Douglas, M.S., CCC-SLP
• Michelle Lee Downey, LCSW
• Emilee Doyle

• Behavior Analyst in Quincy, IL
• Providers in Quincy, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; 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.