Individual provider Active NPI

Aquandalla Davis

  • Marriage & Family Therapist
  • New York, NY
National Provider Identifier
1013688928
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
001869 Issued in NY
Practice address
1204 Broadway Ste 1008
New York, NY 10001-4308
Phone
(646) 598-4575
NPI assigned
Sep 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 001869 NY Primary

Addresses

Primary practice location

1204 Broadway Ste 1008
New York, NY 10001-4308

Mailing address

1204 Broadway Ste 1008
New York, NY 10001-4308
Phone (646) 598-4575

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
001869NYMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Fresh Start Marriage and Family Therapy, PLLC Marriage & Family Therapist CurrentSince Mar 19, 2023 Accepting new patients
New York Psychotherapy and Counseling Center PastSince Sep 1, 2021 Accepting new patients
Fresh Start Relational Therapy PastSince Aug 28, 2022 Accepting new patients

Locations

442 5th Ave
#2101
New York, NY 10018
Phone (646) 598-4575

15 W 38th St
Ste 820
New York, NY 10018
Phone (877) 777-9711

1204 Broadway
Ste 1008
New York, NY 10001
Phone (347) 235-2067

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1013688928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 BROADWAY STE 1008",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014308",
            "telephone_number": "646-598-4575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 BROADWAY STE 1008",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014308",
            "telephone_number": "646-598-4575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "AQUANDALLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-22",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "001869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.