Active NPI
Donna M Davis, LCSW, LMFT, CSAT
- Marriage & Family Therapist
- Charlotte, NC
National Provider Identifier
1023234218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 392
- Practice address
- 5950 Fairview Rd Ste 603
Charlotte, NC 28210-3113 - Phone
- (704) 333-3341
- NPI assigned
- Apr 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 215 | NC | |
| Marriage & Family Therapist | 106H00000X | 392 | NC | Primary |
Addresses
Primary practice location
5950 Fairview Rd Ste 603
Charlotte, NC 28210-3113
Mailing address
5950 Fairview Rd Ste 603
Charlotte, NC 28210-3113
Phone (704) 333-3341
Other practice location 1
1300 Baxter St
Suite 255
Charlotte, NC 28204-3053
Phone (704) 333-3341
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 27532 | Other | NC | BLUE CROSS PIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 29, 2022 through Mar 29, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 215 | NC | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548115200000",
"number": "1023234218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5950 FAIRVIEW RD STE 603",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282103113",
"telephone_number": "704-333-3341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5950 FAIRVIEW RD STE 603",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282103113",
"telephone_number": "704-333-3341"
}
],
"practiceLocations": [
{
"address_1": "1300 Baxter St",
"address_2": "Suite 255",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282043053",
"country_code": "US",
"telephone_number": "704-333-3341",
"fax_number": "704-333-3375",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIS",
"first_name": "DONNA",
"middle_name": "M",
"credential": "LCSW, LMFT, CSAT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-17",
"last_updated": "2019-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "215",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NC",
"license": "392",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PIN",
"identifier": "27532",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.