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

Maxine Jean Douglas, LCSW

Individual provider Clinical Social Worker · NPI 1871181974

Maxine Jean Douglas, LCSW is a Clinical Social Worker in Brookhaven, Georgia. Qualified in 1997, 29 years ago. Practices as a sole proprietor. Licensed in Georgia.

Years since qualifying
29
Licensed in
GA
In the registry since
2021
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

10 Perimeter Summit Blvd NE Unit 4408
Brookhaven, GA 30319-1487
Phone: (404) 468-3284
Fax: (678) 309-1039
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence CSW005840 (GA)

Record details

NPI number1871181974
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedJanuary 5, 2021
Last updated in NPPESJanuary 5, 2021
Certification dateJanuary 5, 2021

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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