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MR. DOUGLAS J. PARK PH.D
NPI 1912967019
Psychologist - Clinical in Dearborn, MI

Active since March 24, 2006PECOS Enrolled
2314 MONROE ST, DEARBORN, MI 48124(313) 565-5937 Get Directions Write a Review

NPPES record last updated: May 19, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Douglas J. Park Ph.d NPPES

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

MR. DOUGLAS J. PARK PH.D (NPI 1912967019) is an individual clinical provider in Dearborn, Michigan, licensed in Michigan (6301011777) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912967019
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameMR. DOUGLAS J. PARKCredential: PH.D
Location Address2314 MONROE STDearborn, MI 48124-3010
Mailing Address2314 Monroe StDearborn, MI 48124-3010 · (313) 565-5937
Phone(313) 565-5937
Sole ProprietorYes
Enumeration DateMarch 24, 2006
Last NPPES UpdateMay 19, 2014
✔ NPI 1912967019 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in MI · 6301011777
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
2314 MONROE ST, Dearborn, MI 48124
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Other Identifiers 3

Other680H216560MI · Blue Cross Blue Shield
Medicare ID-Type UnspecifiedOP14850MI
Other680H216560MI · Blue Care Network

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Priority Health, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Douglas J. Park Ph.d is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 48124 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
$177.36 typical visit price
range $58.04 – $177.36
Typical copayment $44.34 (range $14.51 – $44.34)
Most-billed visit code 99205
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

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

MS. MICHELLE MARIE FARKAS PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
2314 MONROE ST
DEARBORN, MI 48124
Wayne County (313) 562-6633
MANUEL DUMLAO MD PC
Clinic/Center (Adult Mental Health)
2314 MONROE ST
DEARBORN, MI 48124
Wayne County (313) 562-6633
DR. MANUEL DUMLAO MD
Psychiatry & Neurology (Psychiatry)
2314 MONROE ST
DEARBORN, MI 48124
Wayne County (313) 562-6633
KATEN PARK MSW
Counselor (Mental Health)
2314 MONROE ST
DEARBORN, MI 48124
Wayne County (313) 565-5937
RAAD JAJO, M.D., PLLC
Psychologist (Clinical)
2314 MONROE ST
DEARBORN, MI 48124
Wayne County (313) 562-6633
RAAD JAJO M.D., PLLC
Psychiatry & Neurology (Psychiatry)
2314 MONROE ST
DEARBORN, MI 48124
Wayne County (313) 562-6633
MRS. NORMA KEIL SHAW LMSW
Social Worker (Clinical)
2314 MONROE ST
DEARBORN, MI 48124
Wayne County (313) 562-6633
DR. ALICJA DORATA WASILEWSKI M.D.
Psychiatry & Neurology (Psychiatry)
2314 MONROE ST
DEARBORN, MI 48124
Wayne County (313) 562-6633

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 Douglas Park's NPI number?

The NPI number for Douglas Park is 1912967019. It was assigned to this individual provider in the NPPES registry on March 24, 2006.

Where is Douglas Park located?

Douglas Park practices at 2314 Monroe St, Dearborn, MI 48124. The listed phone number is (313) 565-5937.

What is Douglas Park's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Douglas Park enrolled in Medicare?

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

What insurance does Douglas Park accept?

Health plans from Priority Health and Providence Health Plan list Douglas Park as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Douglas Park was last updated on May 19, 2014. 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.