Suzyn Mary Douglass-Everhard, M.A.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

172576 Issued in KY

Practice address

650 Joel Dr
Fort Campbell, KY 42223-5318

Phone

(270) 798-8400

NPI assigned

Dec 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Ms. Suzyn Mary Douglass Professional name

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1982762357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 ERLANGER RD",
            "address_2": "SUITE 204",
            "city": "ERLANGER",
            "state": "KY",
            "postal_code": "410181468",
            "telephone_number": "859-342-6444",
            "fax_number": "859-342-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-798-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "495 Erlanger Rd",
            "address_2": "Suite 204",
            "address_purpose": "LOCATION",
            "city": "Erlanger",
            "state": "KY",
            "postal_code": "410181468",
            "country_code": "US",
            "telephone_number": "859-342-6444",
            "fax_number": "859-342-0999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLASS-EVERHARD",
        "first_name": "SUZYN",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "KY-0854",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "64067",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "172576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1982762357",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "suzyn.m.douglass-everhard.civ@mail.mil",
            "affiliation": "N",
            "endpointDescription": "professional DOD work email",
            "address_1": "650 Joel Dr",
            "city": "Fort Campbell",
            "state": "KY",
            "country_code": "US",
            "postal_code": "422235318",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "suzyn.m.douglass-everhard.civ@mail.mil",
            "affiliation": "N",
            "endpointDescription": "DOD",
            "address_1": "650 Joel Dr",
            "city": "Fort Campbell",
            "state": "KY",
            "country_code": "US",
            "postal_code": "422235318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SUZYN",
            "last_name": "DOUGLASS",
            "middle_name": "MARY",
            "prefix": "MS.",
            "credential": "LPC, LPCC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Amanda Marie Diemer
• Corey Lynn Dietze, DPT, ATC-LAC
• Earvean Lashawnda Diggs, DSW, LCSW, CFCS
• Ashley Marie Dimeo, DMD
• Julian Macon Dismukes III, DMD
• Thomas Peter Dove, MD
• Peter Michael Doyle, DPT
• Jordan Draheim
• Gwendolyn Renee Drake, PSY.D.
• Nicholas Demetrios Paul Drakos, MD

• Professional Counselor in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Professional Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; 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.