Stephanie Machelle Douglass

PMHNP-BC | Nurse Practitioner - Psych/Mental Health | 11+ years Exp

5600 Goodman Rd, Ste B, Olive Branch
  Mississippi, 38654-7002
662-890-7010
Accepts Medicare Nurse Anesthetist in Olive Branch, Mississippi.
Stephanie Machelle Douglass is a Olive Branch, Mississippi based nurse practitioner with 11 years of experience in Psych/Mental Health. She completed her graduation in 2014. She accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Stephanie Machelle Douglass is R863198 for Psych/Mental Health in Mississippi. Her current practice location is 5600 Goodman Rd, Ste B, Olive Branch. Patients can reach her at 662-890-7010 or can fax her at 662-890-7044. Stephanie Machelle Douglass is PMHNP-BC with specialization in Psych/Mental Health and her NPI number (Unique professional ID assigned by NPPES) is 1386904803.
Stephanie Machelle Douglass provides a full range of primary mental health care services, including biopsychosocial assessment and diagnosis of patients with mental illness and co-occurring disorders. Treatment modalities include both medication and psychotherapeutic management. Psych/Mental Health Nurse Practitioner (PMHNP) works in a variety of settings, including inpatient, emergency and community-based mental health services.
Complete Profile:
Stephanie Machelle Douglass speciality, credentials, practice address, contact phone number and fax are as below. Patients can call on the below given phone number for appointment.
Name: Stephanie Machelle Douglass
Specialization: Psych/Mental Health Nurse Practitioner (PMHNP)
Gender:Female
Credentials: PMHNP-BC
Experience: 11+ years
Medical School Attended:Other
Graduation Year:2014
Accepts Medicare Assignment:Yes
Practice Address:5600 Goodman Rd, Ste B, Olive Branch,
Mississippi, 38654-7002
Phone:662-890-7010
Fax:662-890-7044
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
PAC ID: 4981960184
Enrollment ID: I20171103000832
NPI Number: 1386904803
NPI Enumeration Date: 17 May, 2012
NPI Last Update On: 28 Sep, 2020

Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Stephanie Machelle Douglass are as mentioned below.
License NumberSpecializationStateStatus
R863198Psych/Mental Health MississippiPrimary
Group Practice:
Group practices are practice of medicine by a group of NPs who share their premises and other resources. Following list states all the group name with which Stephanie Machelle Douglass is associated with along with the number of members in that group.
Organization Name (Group PAC ID) Members
Pure Light Psychiatry Llc (4789019365)2
Other Medical Identifiers:
Other legacy medical identifiers associated with Stephanie Machelle Douglass such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
IdentifierTypeStateIssuer
08121826MedicaidMississippi
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address: Stephanie Machelle Douglass
5600 Goodman Rd, Ste B
Olive Branch, Mississippi
Zip: 38654-7002
Phone Number: 662-890-7010
Fax Number: 662-772-5940
Patients can reach Stephanie Machelle Douglass at 5600 Goodman Rd, Ste B, Olive Branch, Mississippi or can call to book an appointment on 662-890-7010.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 10 March, 2025.