Lawonda Manette Davis, MA, LPC

Individual provider Active NPI Professional Counselor · Weldon Spring, MO

NPI 1003394503 · NPPES record last updated Oct 9, 2024

Key facts

NPI
1003394503
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
2020037394 (MO)
Practice address
13 Running Waters CT
Weldon Spring, MO 63304-2413
Phone
(636) 699-0636
NPI assigned
Aug 6, 2018
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2020037394MOMDMental Health Counselor
11637OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lawondadavis@tdh.allscriptsdirect.net

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2020037394 MO
Professional Counselor 101YP2500X 11637 OK
Professional Counselor 101YP2500X 2020037394 MO Yes

Addresses

Primary practice location

13 Running Waters CT
Weldon Spring, MO 63304-2413

Mailing address

13 Running Waters CT
Weldon Spring, MO 63304-2413
Phone (636) 699-0636

Other providers in Weldon Spring, MO

All providers in Weldon Spring, MO · Professional Counselor in Missouri

Sources for this page

Verify at the official NPI Registry.