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BRUCE G DOUGLASS PHD PC
NPI 1659513208
Psychologist - Family in Traverse City, MI

Active since March 28, 2009
5088 VILLAGE LANE CT, TRAVERSE CITY, MI 49685(231) 342-5877(231) 943-2108 Get Directions Write a Review

NPPES record last updated: February 27, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Bruce G Douglass Phd Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRUCE G DOUGLASS PHD PC (NPI 1659513208) is a healthcare organization registered as a family in Traverse City, Michigan and active in the NPI registry since March 2009. The organization lists Bruce G Douglass, Manager, as its authorized official.

NPPES Registry Identity

NPI1659513208
Entity TypeOrganization
Primary Taxonomy103TF0000X
Legal Business NameBRUCE G DOUGLASS PHD PC
Location Address5088 VILLAGE LANE CTTraverse City, MI 49685-6924
Mailing Address5088 Village Lane CtTraverse City, MI 49685-6924 · (231) 342-5877 · Fax (231) 943-2108
Phone(231) 342-5877
Fax(231) 943-2108
Organization SubpartNo
Authorized OfficialBruce G DouglassManager · (231) 342-5877
Enumeration DateMarch 28, 2009
Last NPPES UpdateFebruary 27, 2021
NPPES CertifiedFebruary 27, 2021
✔ NPI 1659513208 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · FamilyBehavioral Health & Social Service Providers
Taxonomy Code103TF0000X
License✔ Licensed in MI · 6301003193
Definition
A psychologist whose specialty is founded on principles of systems theory with the interpersonal system of the family the focus of assessment, intervention and research.
5088 VILLAGE LANE CT, Traverse City, MI 49685
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Other Identifiers 1

Other680B84509MI · Bcbsm

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bruce G Douglass Phd PC's NPI number?

The NPI number for Bruce G Douglass Phd PC is 1659513208. It was assigned to this organization in the NPPES registry on March 28, 2009.

Where is Bruce G Douglass Phd PC located?

Bruce G Douglass Phd PC is located at 5088 Village Lane Ct, Traverse City, MI 49685. The listed phone number is (231) 342-5877.

What is Bruce G Douglass Phd PC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Family, with taxonomy code 103TF0000X.

When was this NPI record last updated?

The NPPES record for Bruce G Douglass Phd PC was last updated on February 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.