Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Stephanie Machelle Douglass, PMHNP-BC

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1386904803

Stephanie Machelle Douglass, PMHNP-BC is a Nurse Practitioner in Olive Branch, Mississippi. Qualified in 2014, 12 years ago. Practices with Pure Light Psychiatry LLC, a 2-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
12
Licensed in
MS
In the registry since
2012
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

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Practice location Address checks out

5600 Goodman Rd Ste B
Olive Branch, MS 38654-7002
Phone: (662) 890-7010
Fax: (662) 890-7044
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence R863198 (MS)

Record details

NPI number1386904803
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP-BC
Sole proprietorYes
NPI enumeratedMay 17, 2012
Last updated in NPPESJune 23, 2025
Certification dateJune 23, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Pure Light Psychiatry Llc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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