Active NPI
Nicholas Davis, LPC
- Professional Counselor
- Chubbuck, ID
National Provider Identifier
1043101066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4671469
- Practice address
- 4737 S Afton PL Ste a
Chubbuck, ID 83202-2317 - Phone
- (208) 417-0623
- NPI assigned
- Jul 9, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4671469 | ID | Primary |
Addresses
Primary practice location
4737 S Afton PL Ste a
Chubbuck, ID 83202-2317
Mailing address
5033 Hawthorne Rd Apt 15
Pocatello, ID 83202-2261
Phone (208) 269-0601
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4671469 | ID | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| T Help | Current | Accepting new patients | |
| Anchor and Soul Counseling LLC | Past | Accepting new patients |
Locations
4737 S Afton Pl
#A
Pocatello, ID 83202
Phone (208) 251-4951
Organizations & group practices 2
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.
-
- Adult Mental Health Clinic/Center
- Pocatello, ID
- NPI 1679497911
-
- Community/Behavioral Health Agency
- Chubbuck, ID
- NPI 1649607250
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1752019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752019200000",
"number": "1043101066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5033 HAWTHORNE RD APT 15",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832022261",
"telephone_number": "208-269-0601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4737 S AFTON PL STE A",
"city": "CHUBBUCK",
"state": "ID",
"postal_code": "832022317",
"telephone_number": "208-417-0623"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "NICHOLAS",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-07-09",
"last_updated": "2025-07-09",
"certification_date": "2025-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "4671469",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chubbuck, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.