Douglas, Rick D
Douglas, Rick D is an individual health care provider with primary practice located at 4411 Kinsey Dr Apt. 905, Tyler TX 75703-1015. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Douglas, Rick D can be contacted via phone (903) 273-2642.Contact Information
Primary practice address
4411 Kinsey Dr Apt. 905
Tyler TX 75703-1015
Phone: (903) 273-2642
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 21438 | Texas |
Profile Details
| NPI number | 1659401107 |
|---|---|
| LBN Legal business name | Douglas, Rick D |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 6th, 2007 |
| Last updated | Nov 15th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659401107 | NPPES |
| Texas | MEDICAID | 040460001 | |
| Texas | Other | 87039Q |
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