MEDICARE: MRS. FLORENCE DOUGHTY LCSW, PIP

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	1041C0700X	Clinical Social Worker	1980C	AL

General Provider Information

NPI Number	:	1043275746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. FLORENCE DOUGHTY LCSW, PIP

Provider Business Mailing Address
First Line	:	14370 MUIRFIELD DR
Second Line	:
City	:	ATHENS
State	:	AL
Zip	:	35613-8122
Country	:	US
Telephone Number	:	256-216-1526
Fax Number	:

Provider Business Practice Location Address
First Line	:	475 PROVIDENCE MAIN ST NW
Second Line	:	SUITE 401
City	:	HUNTSVILLE
State	:	AL
Zip	:	35806-4815
Country	:	US
Telephone Number	:	256-716-0811
Fax Number	:

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

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	02/08/2017

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