GRYPHAN ANTHONY ALEXANDER DOUGLAS (MSW, LISW) – Clinical Social Worker, NPI 1649840612

GRYPHAN ANTHONY ALEXANDER DOUGLAS (MSW, LISW) is a healthcare provider. based in Clive, Iowa. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials MSW, LISW. They hold a License No. 107993 (IA). The NPI Number for GRYPHAN ANTHONY ALEXANDER DOUGLAS (MSW, LISW) is 1649840612

Main info

Male
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
GRYPHAN ANTHONY ALEXANDER DOUGLAS (MSW, LISW)
NPI
1649840612
Phone
(515) 393-6702
Address
12247 STRATFORD DR
Enumeration Date
30 June 2021
Last Update Date
10 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5153463999
Graduation Year
2021 (5 years ago)
PAC ID
5193169233
Group Practice PAC ID
1850742586
Professional Enrollment ID
I20240216003042
Address ID
IA503258147CL12247DRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness85
Years active:4State licenses:1Digital endpointsOther names

828 CLINICAL SOCIAL WORKER in IA

Provider Addresses for GRYPHAN ANTHONY ALEXANDER DOUGLAS (MSW, LISW)

  • 12247 STRATFORD DR

    CLIVE, IA 503258147

    Phone: (515) 393-6702

    Type: Mailing

  • 808 5TH AVE

    DES MOINES, IA 503091307

    Phone: (515) 244-2267

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240216003042IClinical Social WorkerIATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 50325)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1850742586View full group profile
NameSpecialtyState
Mental Health CounselorIA
Mental Health CounselorIA
Marriage And Family TherapistIA
Mental Health CounselorIA
Mental Health CounselorIA
Clinical Social WorkerIA
Mental Health CounselorIA
Mental Health CounselorIA

Reviews

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Frequently asked questions

What federal number belongs to GRYPHAN ANTHONY ALEXANDER DOUGLAS (MSW, LISW)?
The federal identifier for GRYPHAN ANTHONY ALEXANDER DOUGLAS (MSW, LISW) is NPI 1649840612.
Does this profile mean GRYPHAN ANTHONY ALEXANDER DOUGLAS (MSW, LISW) is currently active?
Yes — GRYPHAN ANTHONY ALEXANDER DOUGLAS (MSW, LISW) appears active in the national provider directory.
Can you summarize GRYPHAN ANTHONY ALEXANDER DOUGLAS (MSW, LISW)'s specialty in plain language?
Clinically, the directory lists GRYPHAN ANTHONY ALEXANDER DOUGLAS (MSW, LISW) with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where is GRYPHAN ANTHONY ALEXANDER DOUGLAS (MSW, LISW)'s primary listing?
We display Clive, Iowa because that is what the record indicates for GRYPHAN ANTHONY ALEXANDER DOUGLAS (MSW, LISW).
How can I contact GRYPHAN ANTHONY ALEXANDER DOUGLAS (MSW, LISW)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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