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General NPI Number Information
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NPI Number | 1235018391
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Entity Type | Organization
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Legal Business Name | DOUGLAS PSYCHOTHERAPY SERVICES LLC
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Dates
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Enumeration Date | 09/01/2025
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 1166 E BIG BEAVER RD
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City | TROY
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State | MI
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Zip | 48083-1934
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Country | US
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Telephone | 248-770-5816
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Fax |
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Provider Business Mailing Address
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Address Line | 858 LYNHAVEN CT
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-3028
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Country | US
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Telephone | 248-766-1563
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JEFFREY DOUGLAS JR.
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Credential | LMSW
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Telephone | 248-766-1563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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