Search › Georgia › 104100000X
Mark Douglas, LCSW
NPI 1508475062 · on the registry since 2020
Practice
- Address
- 303 Fraser Dr
Hinesville, GA 31313 - Phone
- (912) 877-2227
- Fax
- (912) 877-2332
- Organisation at this address
- Diversity Health Center Inc
Diversity Health Center IncInferred from a shared address, not stated in the registry. - Clinicians at this address
- 22
Additional practice sites
- 213 N Mcdonald St Ste A&B, Ludowici, GA
- 244 Peachtree St, Jesup, GA
- 502 E General Stewart Way Ste A, Hinesville, GA
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2020-07-30
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia