THERESA A DOUGLAS (NPI# 1376971226) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376971226 |
| Entity Type | Individual |
| Full Name | THERESA A DOUGLAS |
| Credential | MS., LPC-T |
| Practice Address |
17 S. River St 254 Janesville WI 53548-3863 |
| Mailing Address |
17 S. River St. Suite 254 Janesville WI 53548-3862 |
| Practice Telephone | 6087555260 |
| Practice Fax Number | 6087555267 |
| Mailing Telephone | 6087555260 |
| Mailing Fax Number | 6087555267 |
| Enumeration Date | 2013-10-30 |
| Last Update Date | 2013-10-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 1844-226 | WI | Behavioral Health & Social Service Providers |
| Street Address |
17 S. RIVER ST 254 |
| City | JANESVILLE |
| State | WI |
| Zip Code | 53548-3863 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558464115 | Sarah Louise Hessenauer | Social Worker | 17 S. River St, Suite 254, Janesville, WI 53548 | 2006-09-07 |
| 1689026965 | Mikhaela K Creekmore | Social Worker | 17 S. River St, Suite 254, Janesville, WI 53548-3863 | 2016-07-11 |
| 1922401918 | Matthew R Garvoille | Counselor | 17 S. River St, Suite 254, Janesville, WI 53548-3863 | 2014-10-03 |
| 1205274818 | Rebekah E. Dresang | Counselor | 17 S. River St, Suite 254, Janesville, WI 53548-3863 | 2013-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578846010 | Patricia Ann Sheets | Licensed Vocational Nurse | 316 N. Terrace St., Janbesville, WI 53548 | 2011-09-21 |
| 1760658983 | Kristy Kay Prentice Kerl | Dental Hygienist | 121 Jonathon Dr, Janesville, WI 53548 | 2008-05-07 |
| 1316005978 | City of Janesville | Emergency Medical Technician, Paramedic | 18 N Jackson St, Janesville, WI 53548 | 2006-12-05 |
| 1073548327 | Mary Katherine Cefalu | Registered Nurse | 17 S. River, Suite 254, Janesville, WI 53548 | 2006-07-12 |
| 1699707950 | Gary Lavern Jones | Counselor | 175 River, Suite 254, Janesville, WI 53548 | 2006-07-07 |
| 1295767424 | Michael Stuart Kaye | Clinical Neuropsychologist | 17 S River St Ste 254, Janesville, WI 53548 | 2006-07-07 |
| 1205864055 | Amy Laurie Roy | Counselor | 17 S River Suite 254, Janesville, WI 53548 | 2006-06-29 |
| 1518903566 | Leota I Larson | Psychologist | 17 S River, Suite 254, Janesville, WI 53548 | 2006-06-20 |
| 1760950414 | North Star Chiropractic LLC | Chiropractor | 21 S Jackson St, Ste 160, Janesville, WI 53548 | 2018-11-10 |
| 1740795608 | Mary Kate Maske | Counselor | 17 S River St Ste 254, Janesville, WI 53548 | 2017-12-13 |
| Find all providers in zip 53548 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306464268 | Jennah E Benson | Counselor | 1 S Main Street, Janesville, WI 53545-3977 | 2020-07-08 |
| 1174183545 | Marcia Kay Knutsen | Counselor | 60 S Fremont St, Janesville, WI 53545-2663 | 2019-06-18 |
| 1942760137 | Elizabeth Mcerlean | Counselor | 1905 Center Ave Ste 170, Janesville, WI 53546-2805 | 2019-03-22 |
| 1699707950 | Gary Lavern Jones | Counselor | 175 River, Suite 254, Janesville, WI 53548 | 2006-07-07 |
| 1205864055 | Amy Laurie Roy | Counselor | 17 S River Suite 254, Janesville, WI 53548 | 2006-06-29 |
| 1538792387 | Kelly Bailey | Counselor | 1905 Center Ave, Janesville, WI 53546-2842 | 2020-02-20 |
| 1760833099 | Samantha J Ball | Counselor | 17 S. River St., 254, Janesville, WI 53548-3863 | 2016-06-28 |
| 1598156747 | Kara C Friis | Counselor | 903 Mineral Point Ave, Janesville, WI 53548-2970 | 2015-02-10 |
| 1851795728 | Jackie S Legler | Counselor | 903 Mineral Point Ave, Janesville, WI 53548-2970 | 2014-10-21 |
| 1033512819 | Jayme St. John | Counselor | 113 S Franklin St, Janesville, WI 53548-3812 | 2014-10-07 |
| Find all providers in JANESVILLE | ||||
| City | JANESVILLE |
| Zip Code | 53548 |
Please comment or provide details below to improve the information on THERESA A DOUGLAS.
| 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.