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MAXINE JEAN DOUGLAS LCSW
NPI 1871181974
Social Worker - Clinical in Brookhaven, GA

Active since January 05, 2021PECOS Enrolled
10 PERIMETER SUMMIT BLVD NE UNIT 4408, BROOKHAVEN, GA 30319(404) 468-3284(678) 309-1039 Get Directions Write a Review

NPPES record last updated: January 5, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Maxine Jean Douglas Lcsw NPPES

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

MAXINE JEAN DOUGLAS LCSW (NPI 1871181974) is an individual clinical provider in Brookhaven, Georgia, licensed in Georgia (CSW005840) and active in the NPI registry since January 2021. She is enrolled in Medicare PECOS and is a graduate of Other (1997).

NPPES Registry Identity

NPI1871181974
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMAXINE JEAN DOUGLASCredential: LCSW
Location Address10 PERIMETER SUMMIT BLVD NE UNIT 4408Brookhaven, GA 30319-1487
Mailing Address10 Perimeter Summit Blvd Ne Unit 4408Brookhaven, GA 30319-1487 · (404) 468-3284 · Fax (678) 309-1039
Phone(404) 468-3284
Fax(678) 309-1039
Sole ProprietorYes
Medical School CMSOtherGraduated 1997
Enumeration DateJanuary 5, 2021
NPPES CertifiedJanuary 5, 2021
✔ NPI 1871181974 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 GA · CSW005840
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.
10 PERIMETER SUMMIT BLVD NE UNIT 4408, Brookhaven, GA 30319
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Other Names 1

Former Name (1)Maxine Jean Zandieh Msw

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Maxine Jean Douglas Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4385712355
PECOS Enrollment IDI20260320003816
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30319 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $56.84 – $172.43
Typical copayment $0.00 (range $14.21 – $43.10)
Most-billed visit code NA
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Maxine Douglas's NPI number?

The NPI number for Maxine Douglas is 1871181974. It was assigned to this individual provider in the NPPES registry on January 5, 2021. The provider is also known as Maxine Jean Zandieh Msw.

Where is Maxine Douglas located?

Maxine Douglas practices at 10 Perimeter Summit Blvd NE Unit 4408, Brookhaven, GA 30319. The listed phone number is (404) 468-3284.

What is Maxine Douglas's specialty?

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

Is Maxine Douglas enrolled in Medicare?

Yes. Maxine Douglas is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Maxine Douglas was last updated on January 5, 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.