Madeline C Douglas

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MADELINE C DOUGLAS

Practice address

1255 W Colton Ave
Redlands, CA 92374-2861

Phone

(909) 363-4661

Fax

(909) 495-1634

NPI assigned

Apr 24, 2024

Organization subpart

No

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

Authorized official

Name

Ms. Madeline C Douglas, LCSWNPI 1861769432

Title

Owner

Phone

(217) 607-4215

Specialties & licenses 1

Addresses

Other names 1

• Madeline C Douglas Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Madeline Cassandra Douglas

  • Behavior Analyst
  • Los Angeles, CA
  • NPI 1861769432
  NPD Authorized official

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

{
    "created_epoch": "1713916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713916800000",
    "number": "1992551691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1023",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924021023",
            "telephone_number": "217-607-4215",
            "fax_number": "909-495-1634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 W COLTON AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742861",
            "telephone_number": "909-363-4661",
            "fax_number": "909-495-1634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADELINE C DOUGLAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "MADELINE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-607-4215",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madeline C Douglas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Liberty Macias, PMHNP-BC
• Domonique Mackey
• Kala Marie Maclaughlan, PHARMD
• Christina Maclean, PA-C
• Kelly Ann Macwilkinson, LCSW
• Maefers LLC
• Heidi Maekawa
• Joni Magat, RPH
• Cecilia Magdael, LVN
• Mona Maghsoodi-Deerwester, MD, M.SC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Redlands, CA
• Providers in Redlands, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.