MEDICARE: MS. CAROLINE DOUGLAS LMHC

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	101YM0800X	Mental Health Counselor	23519	FL

General Provider Information

NPI Number	:	1316781123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CAROLINE DOUGLAS LMHC

Provider Business Mailing Address
First Line	:	12529 YELLOW BLUFF RD STE 6/ #310
Second Line	:	UNIT 310
City	:	JACKSONVILLE
State	:	FL
Zip	:	32226
Country	:	US
Telephone Number	:	904-608-9373
Fax Number	:

Provider Business Practice Location Address
First Line	:	3867 HAMMOCK BLUFF DR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32226-4607
Country	:	US
Telephone Number	:	904-608-9373
Fax Number	:

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

Provider Enumeration Date	:	06/25/2024
Last Update Date	:	04/12/2026

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