DR. BRUCE G DOUGLASS (NPI# 1285725424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285725424 |
| Entity Type | Individual |
| Full Name | DR. BRUCE G DOUGLASS |
| Credential | PHD |
| Practice Address |
934 S Garfield Ave Ste C Traverse City MI 49686-2402 |
| Practice Telephone | 2319464419 |
| Mailing Telephone | 2319464419 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2009-03-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 003193 | MI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | TAX ID | 383446966 | 01 |
| MI | BCBS | 680B813220 | 01 |
| Street Address |
934 S GARFIELD AVE STE C |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49686-2402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659513208 | Bruce G Douglass Phd PC | Psychologist | 934 S Garfield Ave Ste C, Traverse City, MI 49686-2402 | 2009-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245877208 | Jessica Marie Glowacki | Behavior Technician | 935 Hemlock St, Traverse City, MI 49686 | 2019-12-09 |
| 1568011542 | Joanne Kressley | Technician | 1693 Maylane Apt. 104, Traverse City, MI 49686 | 2019-09-11 |
| 1194283846 | Pace North | PACE Provider Organization | 2325 Garfield Road N., Traverse City, MI 49686 | 2019-03-12 |
| 1245749225 | Margaret Anne Goss | Speech-Language Pathologist | 1105 E. Eighth Street, Traverse City, MI 49686 | 2017-09-22 |
| 1467981811 | Joan Joyce Shirilla | Social Worker | 2124 Twin Eagles Dr, Traverse City, MI 49686 | 2017-06-08 |
| 1770028763 | Rehab and Mobility Systems, LLC | Durable Medical Equipment & Medical Supplies | 707 Parsons, Traverse City, MI 49686 | 2016-12-29 |
| 1629511316 | Kaitlyn Grangood | Social Worker | 415 Munson Avenue, Ste 101, Traverse City, MI 49686 | 2016-11-29 |
| 1811441132 | Jeffrey D Goodwin | Counselor | 430 Fair St., Traverse City, MI 49686 | 2016-08-04 |
| 1053779918 | Thomas Osborne | Counselor | 2014 Phelps Rd., Traverse City, MI 49686 | 2016-02-08 |
| 1982079588 | Marsha Lynne Dallas | Counselor | 2240 South Airport Road, Traverse City, MI 49686 | 2015-12-08 |
| Find all providers in zip 49686 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174809511 | Elizabeth G Bruning Phd Pllc | Psychologist | 818 Red Dr, Suite 260, Traverse City, MI 49684-4720 | 2011-10-31 |
| 1528101250 | John Ulrich | Psychologist | 102 W Front St, Suite 402, Traverse City, MI 49684-1201 | 2007-02-14 |
| 1740344456 | Barbara Jones Smith | Psychologist | 921 W 11th St # 1w, Traverse City, MI 49684-3002 | 2006-12-20 |
| 1821150277 | Ralph Ford IIi | Psychologist | 909 Gray Rd, Traverse City, MI 49686-9219 | 2006-12-14 |
| 1528154374 | Frank W. Langer | Psychologist | 525 S. Union St., Traverse City, MI 49684 | 2006-10-05 |
| 1376634519 | Gary Vann | Psychologist | 13561 South West Bayshore Dr., Ste. 317, Traverse City, MI 49684 | 2006-09-27 |
| 1942307566 | Lisa L Franseen | Psychologist | 3180 Racquet Club Dr, Ste G, Traverse City, MI 49684-4797 | 2006-09-17 |
| 1316962392 | James B Morrissey | Psychologist | 4020 Copper View Dr, Traverse City, Traverse City, MI 49684-1364 | 2006-07-12 |
| 1447291687 | Amy Borgman | Psychologist | 697 Hannah Ave, Ste D, Traverse City, MI 49686-3399 | 2006-06-09 |
| 1841800067 | Janelle Marie Youngdahl | Psychologist | 1050 Silver Dr, Traverse City, MI 49684-5749 | 2020-08-03 |
| Find all providers in TRAVERSE CITY | ||||
| City | TRAVERSE CITY |
| Zip Code | 49686 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.