Active NPI
Michelle Douglas, MA, LPC
- Professional Counselor
- Spring Branch, TX
National Provider Identifier
1962578765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 19377
- Practice address
- 222 Coneflower Dr
Spring Branch, TX 78070-5039 - Phone
- (830) 515-8988
- Fax
- (830) 438-8051
- NPI assigned
- Nov 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 19377 | TX | Primary |
Addresses
Primary practice location
222 Coneflower Dr
Spring Branch, TX 78070-5039
Mailing address
20475 State Hwy 46 W
Suite 180, Pmb618
Spring Branch, TX 78070-6124
Phone (830) 515-8988
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1795882 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19377 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1962578765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20475 STATE HWY 46 W",
"address_2": "SUITE 180, PMB618",
"city": "SPRING BRANCH",
"state": "TX",
"postal_code": "780706124",
"telephone_number": "830-515-8988",
"fax_number": "830-438-8051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 CONEFLOWER DR",
"city": "SPRING BRANCH",
"state": "TX",
"postal_code": "780705039",
"telephone_number": "830-515-8988",
"fax_number": "830-438-8051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS",
"first_name": "MICHELLE",
"credential": "MA, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-27",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "19377",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1795882",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spring Branch, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.