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

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1578146635

Anthony Imagie-Douglas, LICDC is a Mental Health Counselor in Circleville, Ohio. Qualified in 2009, 17 years ago. Practices with Full Circle Recovery of Circleville, a 4-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
17
Licensed in
OH
In the registry since
2021
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Practice location Address checks out

1875 Stoneridge Dr
Circleville, OH 43113-8956
Phone: (740) 500-1391
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence LICDC.111022 (OH)

Record details

NPI number1578146635
Entity typeIndividual (Type 1)
GenderMale
Credentials LICDC
Sole proprietorNo
NPI enumeratedMay 5, 2021
Last updated in NPPESMay 5, 2021
Certification dateMay 5, 2021
Mailing address2065 Stoneridge Dr, Circleville, OH 43113-8956

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Full Circle Recovery Of Circleville — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Circleville