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KOLETTA DOUGLAS B.S.
NPI 1861584914
Counselor in Bolivar, TN

Active since September 28, 2006
10710 OLD HIGHWAY 64, BOLIVAR, TN 38008(731) 658-6113(731) 658-6165 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Koletta Douglas B.s. NPPES

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

KOLETTA DOUGLAS B.S. (NPI 1861584914) is an individual counselor in Bolivar, Tennessee and active in the NPI registry since September 2006.

NPPES Registry Identity

NPI1861584914
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameKOLETTA DOUGLASCredential: B.S.
Location Address10710 OLD HIGHWAY 64Bolivar, TN 38008-3587
Mailing Address10710 Old Highway 64Bolivar, TN 38008-3587 · (731) 658-6113 · Fax (731) 658-6165
Phone(731) 658-6113
Fax(731) 658-6165
Sole ProprietorNo
Enumeration DateSeptember 28, 2006
Last NPPES UpdateJuly 9, 2007
✔ NPI 1861584914 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
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.
10710 OLD HIGHWAY 64, Bolivar, TN 38008
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Other Providers at the Same Location NPPES 20

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

TYNETTA QUNIQUE BEAMON-SIMPSON APRN
Nurse Practitioner (Psychiatric/Mental Health)
10710 OLD HIGHWAY 64
BOLIVAR, TN 38008
Hardeman County (731) 658-6113
MARVIN GARY GILL M.ED.
Counselor
10710 OLD HIGHWAY 64
BOLIVAR, TN 38008
Hardeman County (731) 658-6113
HARLIS REESE MA
Counselor
10710 OLD HIGHWAY 64
BOLIVAR, TN 38008
Hardeman County (731) 658-6113
MICHELLE GUIA BS
Counselor
10710 OLD HIGHWAY 64
BOLIVAR, TN 38008
Hardeman County (731) 658-6113
LAFONDA BOYD BLS
Counselor
10710 OLD HIGHWAY 64
BOLIVAR, TN 38008
Hardeman County (731) 658-6113
RUBYE COUCHOUD APRN
Nurse Practitioner (Psychiatric/Mental Health)
10710 OLD HIGHWAY 64
BOLIVAR, TN 38008
Hardeman County (731) 658-6113
EDWARD DANIEL HAMER MSW
Counselor
10710 OLD HIGHWAY 64
BOLIVAR, TN 38008
Hardeman County (731) 658-6113
PATRICIA N WARREN
Nurse Practitioner (Psychiatric/Mental Health)
10710 OLD HIGHWAY 64
BOLIVAR, TN 38008
Hardeman County (731) 658-6113

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 Koletta Douglas's NPI number?

The NPI number for Koletta Douglas is 1861584914. It was assigned to this individual provider in the NPPES registry on September 28, 2006.

Where is Koletta Douglas located?

Koletta Douglas practices at 10710 Old Highway 64, Bolivar, TN 38008. The listed phone number is (731) 658-6113.

What is Koletta Douglas's specialty?

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

When was this NPI record last updated?

The NPPES record for Koletta Douglas was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.