Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bruce G Douglass PHD PC

Organization Family Psychologist · NPI 1659513208

Bruce G Douglass PHD PC is a Family Psychologist in Traverse City, Michigan. Licensed in Michigan. Registered with an NPI since 2009.

Licensed in
MI
In the registry since
2009
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5088 Village Lane Ct
Traverse City, MI 49685-6924
Phone: (231) 342-5877
Fax: (231) 943-2108
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Psychologist (primary) Taxonomy 103TF0000X · Licence 6301003193 (MI)

Record details

NPI number1659513208
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Bruce Douglass — Manager · (231) 342-5877
NPI enumeratedMarch 28, 2009
Last updated in NPPESFebruary 27, 2021
Certification dateFebruary 27, 2021
Mailing address5088 Village Lane Ct, Traverse City, MI 49685-6924

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