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MELLISA GAIL DOUGLAS M.ED,LPC
NPI 1720194681
Counselor in Fishersville, VA

Active since August 22, 2006PECOS EnrolledAccepts Medicare Assignment
71 WILSON BLVD STE A1, FISHERSVILLE, VA 22939(540) 949-4202(540) 886-7380 Get Directions Write a Review

NPPES record last updated: December 2, 2013. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mellisa Gail Douglas M.ed,lpc NPPES

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

MELLISA GAIL DOUGLAS M.ED,LPC (NPI 1720194681) is an individual counselor in Fishersville, Virginia, licensed in Virginia (0701004135) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2004).

NPPES Registry Identity

NPI1720194681
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameMELLISA GAIL DOUGLASCredential: M.ED,LPC
Location Address71 WILSON BLVD STE A1Fishersville, VA 22939-2283
Mailing Address1302 Burnsville RdWilliamsville, VA 24487-2148 · (540) 396-3379 · Fax (540) 886-7380
Phone(540) 949-4202
Fax(540) 886-7380
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateAugust 22, 2006
Last NPPES UpdateDecember 2, 2013
✔ NPI 1720194681 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License✔ Licensed in VA · 0701004135
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License 17005 (TX)
71 WILSON BLVD STE A1, Fishersville, VA 22939
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Other Identifiers 1

Medicaid162090801TX

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mellisa Gail Douglas M.ed,lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6103340971
PECOS Enrollment IDI20250414002600
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Mellisa Douglas reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Augusta Psychological Associates
Same address
Psychosomatic Medicine
73 WILSON BLVD STE 101
Fishersville, VA 22939
  • Reassigned Medicare billing, Virginia enrollment
  • 5 clinicians in this Medicare group
NPI 1053416495 (540) 949-4202
Mental Health Specialty Group PA
144 mi
Mental Health
110 N CORCORAN ST FL 5
Durham, NC 27701
  • Reassigned Medicare billing, Virginia enrollment
  • 128 clinicians in this Medicare group
NPI 1801472634 (323) 205-7088

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELIZABETH KING PHD
Psychologist (Clinical)
71 WILSON BLVD STE A1
FISHERSVILLE, VA 22939
Augusta County (540) 949-4202

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 Mellisa Douglas's NPI number?

The NPI number for Mellisa Douglas is 1720194681. It was assigned to this individual provider in the NPPES registry on August 22, 2006.

Where is Mellisa Douglas located?

Mellisa Douglas practices at 71 Wilson Blvd Ste A1, Fishersville, VA 22939. The listed phone number is (540) 949-4202.

What is Mellisa Douglas's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Mellisa Douglas enrolled in Medicare?

Yes. Mellisa Douglas is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Mellisa Douglas's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mellisa Douglas reassigns Medicare benefits to 2 organizations: Augusta Psychological Associates (Fishersville, VA) and Mental Health Specialty Group PA (Durham, NC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mellisa Douglas's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mellisa Douglas was last updated on December 2, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.