Eileen Kate Douglas, PH.D., LPC, ATR-BC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

0701005556 Issued in VA

Practice address

825 Fairfax Ave # 710
Norfolk, VA 23507-1914

Phone

(757) 446-5888

NPI assigned

Nov 14, 2022

Sex

Female

Sole proprietor

Yes

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

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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 and National Provider Directory roles.

• Evms Academic Physicians and Surgeons Health Services Foundation

  • Internal Medicine Physician
  • Norfolk, VA
  • NPI 1003887118
  Medicare reassignment NPD

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1952019432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1980",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235011980",
            "telephone_number": "757-446-5895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 FAIRFAX AVE # 710",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071914",
            "telephone_number": "757-446-5888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "EILEEN",
        "middle_name": "KATE",
        "name_prefix": "Dr.",
        "credential": "PH.D., LPC, ATR-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-14",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "VA",
            "license": "0701005556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanne F. Doucette, L.C.S.W.
• Brian Dougherty, MB, BCH, BAO
• Leslie Zapata Dougherty, LPC
• William M Dougherty, MD
• Douglas John Hughes DDS PC
• Marcia Douglas, CMA, CNA, PCA
• Sharese Joell Douglas, LPTA
• Erin P Douglass, M.ED., CCC SLP
• Alex Dow, BCBA, LBA
• Donna Dowell, ANP

• Counselor in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.