Davona D Blackhorse, LAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LAC-20688 Issued in AZ

Practice address

2204 S Dobson Rd Ste 201
Mesa, AZ 85202-6457

Phone

(602) 230-7373

NPI assigned

Sep 15, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1043098643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 N CENTRAL AVE STE 500",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122639",
            "telephone_number": "602-230-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 S DOBSON RD STE 201",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852026457",
            "telephone_number": "602-230-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKHORSE",
        "first_name": "DAVONA",
        "middle_name": "D",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-15",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LAC-20688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Black, COTA
• Timothy E Black, MD
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• Patrick Wayne Blackburn, MD
• Jared Blacker, DDS
• Carmen L Blackshear, HOME HEALTH AID
• Maria Elaine Blahut
• Jackie Lynn Blair-Merritt, PT
• Debra Lynn Blair
• Julie Blair, LMSW

• Mental Health Counselor in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.