Provider Demographics
NPI:1427283829
Name:PLAEGER, DOUGLAS ADAM (MA, LPC)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:ADAM
Last Name:PLAEGER
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 COUNTY ROAD 90
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-4890
Mailing Address - Country:US
Mailing Address - Phone:713-417-8218
Mailing Address - Fax:
Practice Address - Street 1:2225 COUNTY ROAD 90
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-4890
Practice Address - Country:US
Practice Address - Phone:713-417-8218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62161101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX203064501Medicaid