Collin Thomas Davies, M.A., LPE-I

Primary specialty

PsychologistTaxonomy code 103T00000X

License

13-22EI Issued in AR

Practice address

2850 Prince St Ste 53
Conway, AR 72034-3600

Phone

(501) 764-3002

Fax

(866) 514-7628

NPI assigned

Jul 18, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 24, 2024 through Apr 24, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Central Arkansas Testing & Therapy Center

  • Psychologist
  • Conway, AR
  • NPI 1699482281

  Professional

  NPD Authorized official
• Chenal Family Therapy, PLC

  • Mental Health Counselor
  • Little Rock, AR
  • NPI 1356604219
  NPD (past)
• Coco Psychiatric Services PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Little Rock, AR
  • NPI 1326647918
  NPD (past)

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1033464870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 PRINCE ST STE 53",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720343600",
            "telephone_number": "501-764-3002",
            "fax_number": "866-514-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 PRINCE ST STE 53",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720343600",
            "telephone_number": "501-764-3002",
            "fax_number": "866-514-7628"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 W Searcy St",
            "address_purpose": "LOCATION",
            "city": "Heber Springs",
            "state": "AR",
            "postal_code": "725433840",
            "country_code": "US",
            "telephone_number": "501-270-9503",
            "fax_number": "501-235-3866",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18 Canten Cv",
            "address_purpose": "LOCATION",
            "city": "Greenbrier",
            "state": "AR",
            "postal_code": "720585008",
            "country_code": "US",
            "telephone_number": "870-532-3406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIES",
        "first_name": "COLLIN",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "M.A., LPE-I",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-18",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P2109018",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AR",
            "license": "13-22EI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Davenport, RECOVERY ASSISTANT
• Sydney Davenport, RN
• Charles S Davidson, MED.,ATC.,CSCS.,CEAS
• Haley Davidson
• Rose Davidson, OT
• Victoria Danielle Davies, LCSW
• Aaron Davis, CMP
• Andriana Renee Davis, MHPP
• Brian W Davis, LCSW
• Dale Davis, CMP

• Psychologist in Conway, AR
• Providers in Conway, AR by specialty
• Psychologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.

Verify at the official NPI Registry.