Moses Douse Jr., CASAC 2-20038

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

20038 Issued in NY

Practice address

882 Bergen St
Brooklyn, NY 11238-1123

Phone

(718) 613-7510

Fax

(718) 613-7564

NPI assigned

May 14, 2021

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

State licenses

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

{
    "created_epoch": "1620950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1962076927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "882 BERGEN ST",
            "address_2": "OTP-MMT",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11238",
            "telephone_number": "718-613-7510",
            "fax_number": "718-613-7564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "882 BERGEN ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112381123",
            "telephone_number": "718-613-7510",
            "fax_number": "718-613-7564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUSE",
        "first_name": "MOSES",
        "name_suffix": "Jr.",
        "credential": "CASAC 2-20038",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-14",
        "last_updated": "2021-05-14",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "20038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hanna Doulman
• Kathleen Rose Douris, APRN, MSN
• Stella Douros
• Vagelis Theodoros Douros
• Icilda Douse, R,D
• Marie Douyon
• Dov Anesthesiology, PLLC
• Dov M. Kolker M.D.,P.C.
• Dov Phil Anesthesiology Group, PLLC
• Dov Seidenfeld DDS PC

• Addiction (Substance Use Disorder) Counselor in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; 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.