Individual provider · Type 1 NPI

Michele Victoria Douglass, LCSWA, LCASA

Clinical Social Worker · Wake Forest, NC

NPI number 1720873433 Active

Practice location

1740 Heritage Center Dr Ste 201
Wake Forest, NC 27587-9849

Call (919) 556-6501 Map

Fax (919) 556-4933

Mailing address

2704 Evers Dr
Raleigh, NC 27610-4924

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400XLCAS-30416 (NC)
Clinical Social Worker Primary 1041C0700XPO21653 (NC)

Clinical Social Worker: 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 interpers…

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About NPI 1720873433

Michele Victoria Douglass, LCSWA, LCASA's National Provider Identifier is 1720873433, issued on Apr 12, 2025. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Wake Forest, NC. The record was last updated on Apr 22, 2025.