DEVON ELIZABETH DOUGLAS (PSY.D.) – Clinical Psychologist, NPI 1366959751

DEVON ELIZABETH DOUGLAS (PSY.D.) is a healthcare provider. based in Dayton, Ohio. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSY.D.. They hold a License No. P.08167 (OH). The NPI Number for DEVON ELIZABETH DOUGLAS (PSY.D.) is 1366959751

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
DEVON ELIZABETH DOUGLAS (PSY.D.)
NPI
1366959751
Phone
(937) 775-3458
Address
3640 COLONEL GLENN HWY
Enumeration Date
7 January 2018
Last Update Date
13 July 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9372946004
Graduation Year
2019 (7 years ago)
PAC ID
7315342565
Group Practice PAC ID
0143501197
Professional Enrollment ID
I20210825004011
Address ID
OH454581847DA8063XDRXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:8State licenses:1Digital endpointsOther names

1,139 CLINICAL PSYCHOLOGIST in OH

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Provider Addresses for DEVON ELIZABETH DOUGLAS (PSY.D.)

  • 3640 COLONEL GLENN HWY

    DAYTON, OH 454350001

    Phone: (937) 775-3458

    Fax: (937) 775-3434

    Type: Mailing

  • 6520 POE AVE

    SUITE 200

    DAYTON, OH 45414

    Phone: (937) 276-3356

    Fax: (937) 276-9514

    Type: Mailing

  • Eastway Behavioral Healthcare, 600, Wayne Avenue, Twin Towers, Dayton, Montgomery County, Ohio, 45410, United States

    DAYTON, OH 454101122

    Phone: (937) 469-2000

    Type: Location

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: 2021-08-25

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
I20210825004011IClinical PsychologistOHTBD

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 45435)

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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: 0143501197View full group profile
NameSpecialtyState
Clinical PsychologistOH
Clinical PsychologistOH
-OH

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Frequently asked questions

What is the standard ID for DEVON ELIZABETH DOUGLAS (PSY.D.) in the U.S.?
In the U.S., DEVON ELIZABETH DOUGLAS (PSY.D.) is identified by NPI 1366959751.
Is DEVON ELIZABETH DOUGLAS (PSY.D.) currently accepting referrals based on NPI status?
Registry metadata lists DEVON ELIZABETH DOUGLAS (PSY.D.) as active.
What type of care does DEVON ELIZABETH DOUGLAS (PSY.D.) provide?
DEVON ELIZABETH DOUGLAS (PSY.D.)'s profile centers on Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Can patients visit DEVON ELIZABETH DOUGLAS (PSY.D.) in Dayton, Ohio?
For routing, start with Dayton, Ohio for DEVON ELIZABETH DOUGLAS (PSY.D.), then verify phone and hours locally.
Who maintains DEVON ELIZABETH DOUGLAS (PSY.D.)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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