Provider Demographics
NPI:1235018391
Name:DOUGLAS PSYCHOTHERAPY SERVICES LLC
Entity type:Organization
Organization Name:DOUGLAS PSYCHOTHERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:JR
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-766-1563
Mailing Address - Street 1:858 LYNHAVEN CT
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-3028
Mailing Address - Country:US
Mailing Address - Phone:248-766-1563
Mailing Address - Fax:
Practice Address - Street 1:858 LYNHAVEN CT
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-3028
Practice Address - Country:US
Practice Address - Phone:248-766-1563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-01
Last Update Date:2025-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health