MEDICARE: DR. ABISHAG DOUGLAS LPCC, CRC, EDD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	113850	IA
2	101YP2500X	Professional Counselor	2002031	OH
3	101YP2500X	Professional Counselor	265396	KY

General Provider Information

NPI Number	:	1558851923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ABISHAG DOUGLAS LPCC, CRC, EDD.

Provider Business Mailing Address
First Line	:	100 POSTMASTER DR UNIT 845
Second Line	:
City	:	MCDONOUGH
State	:	GA
Zip	:	30253-2806
Country	:	US
Telephone Number	:	937-516-1957
Fax Number	:	877-728-4587

Provider Business Practice Location Address
First Line	:	212 N 2ND ST STE 100
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-1408
Country	:	US
Telephone Number	:	937-516-1957
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2018
Last Update Date	:	03/02/2026

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