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JEFFREY DOUGLASS
NPI 1669647863
Social Worker - Clinical in Coeur D Alene, ID

Active since April 28, 2008Opted out of Medicare · through Jan 1, 2027
613 S DOLLAR ST, COEUR D ALENE, ID 83814(208) 667-8387 Get Directions Write a Review

NPPES record last updated: April 28, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jeffrey Douglass NPPES

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

JEFFREY DOUGLASS (NPI 1669647863) is an individual clinical provider in Coeur D Alene, Idaho, licensed in Idaho (LCSW-1207) and active in the NPI registry since April 2008. He has opted out of Medicare through January 1, 2027.

NPPES Registry Identity

NPI1669647863
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameJEFFREY DOUGLASS
Location Address613 S DOLLAR STCoeur D Alene, ID 83814-3828
Mailing Address613 S Dollar StCoeur D Alene, ID 83814-3828
Phone(208) 667-8387
Sole ProprietorYes
Enumeration DateApril 28, 2008
✔ NPI 1669647863 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in ID · LCSW-1207
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
613 S DOLLAR ST, Coeur D Alene, ID 83814
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Jeffrey Douglass has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2021 through January 1, 2027.

Opt-Out Effective DateJanuary 1, 2021
Opt-Out In Effect ThroughJanuary 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

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 Jeffrey Douglass's NPI number?

The NPI number for Jeffrey Douglass is 1669647863. It was assigned to this individual provider in the NPPES registry on April 28, 2008.

Where is Jeffrey Douglass located?

Jeffrey Douglass practices at 613 S Dollar St, Coeur D Alene, ID 83814. The listed phone number is (208) 667-8387.

What is Jeffrey Douglass's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Jeffrey Douglass enrolled in Medicare?

No. Jeffrey Douglass has opted out of Medicare through January 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jeffrey Douglass was last updated on April 28, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.